Provider Demographics
NPI:1104497031
Name:SIMONS, CLAY A
Entity type:Individual
Prefix:MR
First Name:CLAY
Middle Name:A
Last Name:SIMONS
Suffix:
Gender:M
Credentials:
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Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:23521 PASEO DE VALENCIA
Mailing Address - Street 2:SUITE B7
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92653-2843
Mailing Address - Country:US
Mailing Address - Phone:949-597-0007
Mailing Address - Fax:948-597-0040
Practice Address - Street 1:24582 DEL PRADO
Practice Address - Street 2:SUITE C
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629
Practice Address - Country:US
Practice Address - Phone:949-276-5401
Practice Address - Fax:949-276-5403
Is Sole Proprietor?:No
Enumeration Date:2021-07-01
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist