Provider Demographics
NPI:1285273490
Name:ADKINS, SIMONE LENORE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:SIMONE
Middle Name:LENORE
Last Name:ADKINS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 OLIVER RD # 1208
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-3467
Mailing Address - Country:US
Mailing Address - Phone:707-200-8222
Mailing Address - Fax:
Practice Address - Street 1:333 1ST ST STE 2
Practice Address - Street 2:
Practice Address - City:BENICIA
Practice Address - State:CA
Practice Address - Zip Code:94510-3258
Practice Address - Country:US
Practice Address - Phone:707-200-8222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-06
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA137157106H00000X, 106H00000X
CA114948101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health