MEDICARE: RUBIE DIANNE SIMONSEN

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
1	374J00000X	Doula

General Provider Information

NPI Number	:	1427900786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUBIE DIANNE SIMONSEN

Provider Business Mailing Address
First Line	:	5960 S LAND PARK DR # 732
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95822-3313
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5960 S LAND PARK DR # 732
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95822-3313
Country	:	US
Telephone Number	:	916-777-0090
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

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