Healthcare Provider Details

I. General information

NPI: 1356885230
Provider Name (Legal Business Name): SIMONE STRICKLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2016
Last Update Date: 01/04/2024
Certification Date: 01/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 E TABOR AVE
FAIRFIELD CA
94533-4106
US

IV. Provider business mailing address

1030 E TABOR AVE
FAIRFIELD CA
94533-4106
US

V. Phone/Fax

Practice location:
  • Phone: 707-816-8798
  • Fax:
Mailing address:
  • Phone: 707-816-8798
  • Fax: 877-539-7730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License NumberRBT-16-21021
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: