Provider Demographics
NPI:1578195301
Name:SIMS, FANICA BRINTEE
Entity Type:Individual
Prefix:MRS
First Name:FANICA
Middle Name:BRINTEE
Last Name:SIMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 BERCUT DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95811-0131
Mailing Address - Country:US
Mailing Address - Phone:916-440-1500
Mailing Address - Fax:916-440-1514
Practice Address - Street 1:7225 E SOUTHGATE DR STE D
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2651
Practice Address - Country:US
Practice Address - Phone:916-394-1000
Practice Address - Fax:916-394-1010
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-10
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
Yes175T00000XOther Service ProvidersPeer Specialist
No172V00000XOther Service ProvidersCommunity Health Worker