MEDICARE: LAURA SIMS

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	106H00000X	Marriage & Family Therapist
2	106H00000X	Marriage & Family Therapist	113239	CA

General Provider Information

NPI Number	:	1881972859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA SIMS

Provider Business Mailing Address
First Line	:	2550 E RIVERSIDE DR APT 105
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91761-7377
Country	:	US
Telephone Number	:	424-757-7038
Fax Number	:

Provider Business Practice Location Address
First Line	:	8929 S SEPULVEDA BLVD STE 201
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-3643
Country	:	US
Telephone Number	:	310-645-5227
Fax Number	:

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

Provider Enumeration Date	:	07/25/2011
Last Update Date	:	11/25/2024

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Directions to “ LAURA SIMS ” Practice Location

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