MEDICARE: MR. RUNE SIMMONS

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1447055017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RUNE SIMMONS

Provider Business Mailing Address
First Line	:	2606 YUBA AVE
Second Line	:
City	:	EL CERRITO
State	:	CA
Zip	:	94530-1444
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2606 YUBA AVE
Second Line	:
City	:	EL CERRITO
State	:	CA
Zip	:	94530-1444
Country	:	US
Telephone Number	:	510-566-6759
Fax Number	:

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

Provider Enumeration Date	:	02/17/2025
Last Update Date	:	02/17/2025

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Directions to “ MR. RUNE SIMMONS ” Practice Location

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