Provider Demographics
NPI:1013465194
Name:SIMPSON, TERRY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9454 WILSHIRE BLVD
Mailing Address - Street 2:PENTHOUSE 1026-A
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-2931
Mailing Address - Country:US
Mailing Address - Phone:424-253-8788
Mailing Address - Fax:
Practice Address - Street 1:9454 WILSHIRE BLVD
Practice Address - Street 2:PENTHOUSE 1026-A
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2931
Practice Address - Country:US
Practice Address - Phone:424-253-8788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 28239103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist