Provider Demographics
NPI:1245374966
Name:SIMMS, KATHY MARY (LPT)
Entity type:Individual
Prefix:MS
First Name:KATHY
Middle Name:MARY
Last Name:SIMMS
Suffix:
Gender:F
Credentials:LPT
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Mailing Address - Street 1:6615 VALLEY HI DR # A
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-4601
Mailing Address - Country:US
Mailing Address - Phone:916-681-6300
Mailing Address - Fax:916-681-6354
Practice Address - Street 1:6615 VALLEY HI DR # A
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-4601
Practice Address - Country:US
Practice Address - Phone:916-681-6300
Practice Address - Fax:916-681-6354
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPT26413167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician