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NPI Code Detail

MEDICARE: MRS. DELISA SIMON RN, BSN, MSN, NP-C

MEDICARE: MRS. DELISA SIMON RN, BSN, MSN, NP-C
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 Practitioner95004200CA

General Provider Information

NPI Number : 1851800056
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DELISA SIMON RN, BSN, MSN, NP-C
Provider Business Mailing Address
First Line : 87 FENTON ST STE 210
Second Line :
City : LIVERMORE
State : CA
Zip : 94550-4159
Country : US
Telephone Number : 925-371-8885
Fax Number : 925-371-8884
Provider Business Practice Location Address
First Line : 87 FENTON ST STE 210
Second Line :
City : LIVERMORE
State : CA
Zip : 94550-4159
Country : US
Telephone Number : 925-371-8885
Fax Number : 925-371-8884
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2017
Last Update Date : 07/20/2024

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