MEDICARE: ZHARIA SIMMONS LVN

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	164W00000X	Licensed Practical Nurse	1032712	TX
2	164X00000X	Licensed Vocational Nurse	700577	CA

General Provider Information

NPI Number	:	1548842891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZHARIA SIMMONS LVN

Provider Business Mailing Address
First Line	:	9311 PIONEER BLVD APT 102
Second Line	:
City	:	SANTA FE SPRINGS
State	:	CA
Zip	:	90670-8386
Country	:	US
Telephone Number	:	323-695-8865
Fax Number	:

Provider Business Practice Location Address
First Line	:	9311 PIONEER BLVD APT 102
Second Line	:
City	:	SANTA FE SPRINGS
State	:	CA
Zip	:	90670-8386
Country	:	US
Telephone Number	:	323-695-8865
Fax Number	:

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

Provider Enumeration Date	:	04/26/2021
Last Update Date	:	04/26/2021

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Directions to “ ZHARIA SIMMONS LVN” Practice Location

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