Provider Demographics
NPI:1942695085
Name:SIMMONS, ROXANNE L (MD)
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:L
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 16TH ST
Mailing Address - Street 2:UCSF PEDIATRICS, BOX 0110, 4TH FLOOR, 4551
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-2549
Mailing Address - Country:US
Mailing Address - Phone:415-476-6245
Mailing Address - Fax:415-476-5354
Practice Address - Street 1:550 16TH ST
Practice Address - Street 2:UCSF PEDIATRICS, BOX 0110, 4TH FLOOR, 4551
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158-2549
Practice Address - Country:US
Practice Address - Phone:415-476-6245
Practice Address - Fax:415-476-5354
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1473672084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry