Healthcare Provider Details

I. General information

NPI: 1912853060
Provider Name (Legal Business Name): COLIN SIMSARIAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 CLEMENT ST
SAN FRANCISCO CA
94121-1563
US

IV. Provider business mailing address

734A BAY RD
MILL VALLEY CA
94941-3914
US

V. Phone/Fax

Practice location:
  • Phone: 207-815-8105
  • Fax:
Mailing address:
  • Phone: 207-815-8105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: