Healthcare Provider Details

I. General information

NPI: 1093234056
Provider Name (Legal Business Name): JAMES DAVID GARRETT SIMPSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2017
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 BECK AVE
FAIRFIELD CA
94533-6804
US

IV. Provider business mailing address

275 BECK AVE
FAIRFIELD CA
94533-6804
US

V. Phone/Fax

Practice location:
  • Phone: 555-555-5555
  • Fax:
Mailing address:
  • Phone: 555-555-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number138161
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: