Healthcare Provider Details

I. General information

NPI: 1164030318
Provider Name (Legal Business Name): JOSHUA RYAN SIMPSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2020
Last Update Date: 02/20/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13001 RAMONA BLVD # 1
IRWINDALE CA
91706-3752
US

IV. Provider business mailing address

9864 BALDWIN PL
EL MONTE CA
91731-2202
US

V. Phone/Fax

Practice location:
  • Phone: 626-337-3828
  • Fax:
Mailing address:
  • Phone: 626-433-1311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number128305
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number128305
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number102878
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: