Healthcare Provider Details

I. General information

NPI: 1538093380
Provider Name (Legal Business Name): CRICCELY SIMMONS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35185 BRIGGS RD
MURRIETA CA
92563-2346
US

IV. Provider business mailing address

31564 SETTLERS RD
WINCHESTER CA
92596-6027
US

V. Phone/Fax

Practice location:
  • Phone: 951-304-1580
  • Fax:
Mailing address:
  • Phone: 951-696-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number26107
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: