Provider Demographics
NPI:1508043381
Name:SIMPSON, DANIEL ANTHONY (MA)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:ANTHONY
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 QUAIL CT
Mailing Address - Street 2:
Mailing Address - City:IONE
Mailing Address - State:CA
Mailing Address - Zip Code:95640-5426
Mailing Address - Country:US
Mailing Address - Phone:209-304-2361
Mailing Address - Fax:
Practice Address - Street 1:601 COURT ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:CA
Practice Address - Zip Code:95642-2160
Practice Address - Country:US
Practice Address - Phone:209-304-2361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84344106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist