Provider Demographics
NPI:1104448752
Name:TEI, SIMA
Entity type:Individual
Prefix:
First Name:SIMA
Middle Name:
Last Name:TEI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 UPPER VIA CASITAS APT 14
Mailing Address - Street 2:
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-2262
Mailing Address - Country:US
Mailing Address - Phone:925-699-6692
Mailing Address - Fax:415-461-1359
Practice Address - Street 1:175 UPPER VIA CASITAS APT 14
Practice Address - Street 2:
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2262
Practice Address - Country:US
Practice Address - Phone:925-699-6692
Practice Address - Fax:415-461-1359
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-16
Last Update Date:2020-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA577610171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator