Provider Demographics
NPI:1518131614
Name:SIMMETH, KAY HOLLY (MA, MFT)
Entity Type:Individual
Prefix:MS
First Name:KAY
Middle Name:HOLLY
Last Name:SIMMETH
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3240 CASTERA AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-1661
Mailing Address - Country:US
Mailing Address - Phone:818-681-6627
Mailing Address - Fax:
Practice Address - Street 1:960 E GREEN ST
Practice Address - Street 2:SUITE 292
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2401
Practice Address - Country:US
Practice Address - Phone:818-681-6627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 34863106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist