Provider Demographics
NPI:1629237664
Name:SIMONDS, DAVID RANDALL (MFT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:RANDALL
Last Name:SIMONDS
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:676 LOBOS STREET
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2017
Mailing Address - Country:US
Mailing Address - Phone:831-375-7558
Mailing Address - Fax:831-375-7558
Practice Address - Street 1:621 FOREST AVENUE
Practice Address - Street 2:
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950
Practice Address - Country:US
Practice Address - Phone:831-375-7558
Practice Address - Fax:831-375-7558
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC18602106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist