Healthcare Provider Details

I. General information

NPI: 1649898263
Provider Name (Legal Business Name): MEGAN ELISE SIMPSON PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2020
Last Update Date: 07/09/2020
Certification Date: 07/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4411 E KINGS CANYON RD # 319
FRESNO CA
93702-3604
US

IV. Provider business mailing address

1009 S ROGERS LN
FRESNO CA
93727-5328
US

V. Phone/Fax

Practice location:
  • Phone: 559-600-2383
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: