NPIMap

David Jon Simons, PHD

Individual provider Active NPI Clinical Psychologist · Murphys, CA

NPI 1396868089 · NPPES record last updated Dec 13, 2016

Key facts

NPI
1396868089
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
PSY11868 (CA)
Practice address
150 Big Trees Rd, Suite D
Murphys, CA 95247
Phone
(209) 728-2184
Fax
(858) 514-8425
NPI assigned
Apr 9, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY11868CAMDClinical Psychologist
PSY 11868CAMDForensic Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Matters Clinic Clinical Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X PSY11868 CA
Forensic Psychologist 103TF0200X PSY 11868 CA
Clinical Psychologist 103TC0700X PSY11868 CA Yes

Addresses

Primary practice location

150 Big Trees Rd, Suite D
Murphys, CA 95247

Mailing address

150 Big Trees Rd, Suite D
Murphys, CA 95247
Phone (858) 694-4752

Other providers in Murphys, CA

All providers in Murphys, CA · Clinical Psychologist in California

Sources for this page

Verify at the official NPI Registry.