Provider Demographics
NPI:1982936282
Name:SIMMONS, CELESTE L (PHD)
Entity Type:Individual
Prefix:MISS
First Name:CELESTE
Middle Name:L
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 N PALM AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-2271
Mailing Address - Country:US
Mailing Address - Phone:559-212-3324
Mailing Address - Fax:
Practice Address - Street 1:5151 N PALM AVE STE 800
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-2271
Practice Address - Country:US
Practice Address - Phone:559-623-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31073103TC0700X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional