Healthcare Provider Details

I. General information

NPI: 1134056153
Provider Name (Legal Business Name): JOHN ANDREW SIMMERLING AMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 WILSHIRE BLVD STE 204
SANTA MONICA CA
90401-1737
US

IV. Provider business mailing address

1226 WASHINGTON AVE
SANTA MONICA CA
90403-4216
US

V. Phone/Fax

Practice location:
  • Phone: 323-379-2147
  • Fax:
Mailing address:
  • Phone: 213-282-7670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT162957
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: