Provider Demographics
NPI:1497216261
Name:SIMPSON, THOMAS BLAINE (AOD)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:BLAINE
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:AOD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 PLACIDA PL
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-3684
Mailing Address - Country:US
Mailing Address - Phone:805-963-1836
Mailing Address - Fax:805-963-1653
Practice Address - Street 1:1020 PLACIDA PL
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-3684
Practice Address - Country:US
Practice Address - Phone:805-963-1836
Practice Address - Fax:805-963-1653
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPENDING101Y00000X
CA13029-RAC101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH64085782OtherHUMANA