Provider Demographics
NPI:1386872919
Name:SIMMONS, DEANNA LEE
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:LEE
Last Name:SIMMONS
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 1:136 N SAN MATEO DR
Mailing Address - Street 2:STE 101
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-2777
Mailing Address - Country:US
Mailing Address - Phone:650-373-0777
Mailing Address - Fax:650-373-0778
Practice Address - Street 1:136 N SAN MATEO DR
Practice Address - Street 2:STE 101
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-2777
Practice Address - Country:US
Practice Address - Phone:650-373-0777
Practice Address - Fax:650-373-0778
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor