Provider Demographics
NPI:1891834230
Name:SIMMONS, DEBORAH A (PHD, MFT)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:A
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:PHD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 FLORIBUNDA AVE. .#305
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010
Mailing Address - Country:US
Mailing Address - Phone:650-558-1015
Mailing Address - Fax:650-558-1015
Practice Address - Street 1:405 PRIMROSE RD
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-4064
Practice Address - Country:US
Practice Address - Phone:650-558-1015
Practice Address - Fax:650-558-1015
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC30119106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist