Provider Demographics
NPI:1386894178
Name:SIMKIN, SARAH (SLP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SIMKIN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5146 CAMINITO VISTA LUJO
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2847
Mailing Address - Country:US
Mailing Address - Phone:310-869-7252
Mailing Address - Fax:
Practice Address - Street 1:5146 CAMINITO VISTA LUJO
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2847
Practice Address - Country:US
Practice Address - Phone:310-869-7252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-29
Last Update Date:2023-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17829235Z00000X
AZTSLP5964235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist