Provider Demographics
NPI:1306053186
Name:LEVINSON, SIMONE (PSYD)
Entity type:Individual
Prefix:
First Name:SIMONE
Middle Name:
Last Name:LEVINSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:SIMONE
Other - Middle Name:
Other - Last Name:LEVINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 242
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:MI
Mailing Address - Zip Code:49286
Mailing Address - Country:US
Mailing Address - Phone:517-467-9284
Mailing Address - Fax:844-553-6637
Practice Address - Street 1:1470 MARIA LANA SUITE 200
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596
Practice Address - Country:US
Practice Address - Phone:855-500-6463
Practice Address - Fax:844-555-6337
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY26212103T00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program