Provider Demographics
NPI:1891977047
Name:SIMMONS, KATE W (CMT, CMTPT)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:W
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:CMT, CMTPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 NORWICH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-5223
Mailing Address - Country:US
Mailing Address - Phone:415-533-7598
Mailing Address - Fax:
Practice Address - Street 1:2460 MISSION ST
Practice Address - Street 2:SUITE 212
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2467
Practice Address - Country:US
Practice Address - Phone:415-533-7598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.005237225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist