MEDICARE: DR. TERRY SIMPSON PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PSY 28239	CA

General Provider Information

NPI Number	:	1013465194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERRY SIMPSON PSY.D.

Provider Business Mailing Address
First Line	:	9454 WILSHIRE BLVD
Second Line	:	PENTHOUSE 1026-A
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-2931
Country	:	US
Telephone Number	:	424-253-8788
Fax Number	:

Provider Business Practice Location Address
First Line	:	9454 WILSHIRE BLVD
Second Line	:	PENTHOUSE 1026-A
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-2931
Country	:	US
Telephone Number	:	424-253-8788
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2016
Last Update Date	:	09/16/2016

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