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NPI Code Detail

MEDICARE: JAMES WILLIS SIMMONS II NP

MEDICARE: JAMES WILLIS SIMMONS II NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerNP19879CA

General Provider Information

NPI Number : 1366744492
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES WILLIS SIMMONS II NP
Provider Business Mailing Address
First Line : 4405 WINCANTON RD
Second Line :
City : SALIDA
State : CA
Zip : 95368-9715
Country : US
Telephone Number : 209-482-6840
Fax Number :
Provider Business Practice Location Address
First Line : 830 JEFFERSON AVE
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94063-1804
Country : US
Telephone Number : 650-380-0616
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2010
Last Update Date : 01/16/2026

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