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General NPI Number Information
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NPI Number | 1467285502
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Entity Type | Individual
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Provider Name | AARON SIMMONS
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Gender | Male
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Dates
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Enumeration Date | 08/23/2024
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 4351 BROADWAY
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City | OAKLAND
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State | CA
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Zip | 94611-4612
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Country | US
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Telephone | 510-879-2305
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Fax |
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Provider Business Mailing Address
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Address Line | 58 SPAR CT
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City | PLEASANT HILL
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State | CA
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Zip | 94523-1214
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Country | US
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Telephone | 520-343-6859
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State | CA
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