Individual provider Active NPI

Joann Ruth Simmons, MFT

  • Mental Health Counselor
  • Rancho Cucamonga, CA
National Provider Identifier
1801943436
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MFT28102 Issued in CA
Practice address
10630 Town Center Dr
Suite 111
Rancho Cucamonga, CA 91730-6805
Phone
(951) 204-7124
Fax
(909) 912-8252
NPI assigned
Jan 4, 2007
Last updated
Jul 25, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MFT28102 CA Primary

Addresses

Primary practice location

10630 Town Center Dr
Suite 111
Rancho Cucamonga, CA 91730-6805

Mailing address

10068 Copper Mountain CT
Alta Loma, CA 91737-6830
Phone (951) 204-7124

Other identifiers 1

IdentifierTypeStateIssuer
28102OtherCALICENSE NUMBER

Other names 1

  • Joann Ruth Walker Former name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFT28102CAMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1801943436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10068 COPPER MOUNTAIN CT",
            "city": "ALTA LOMA",
            "state": "CA",
            "postal_code": "917376830",
            "telephone_number": "951-204-7124",
            "fax_number": "909-912-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10630 TOWN CENTER DR",
            "address_2": "SUITE 111",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917306805",
            "telephone_number": "951-204-7124",
            "fax_number": "909-912-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "JOANN",
        "middle_name": "RUTH",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFT28102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "28102",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOANN",
            "last_name": "WALKER",
            "middle_name": "RUTH",
            "credential": "MFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.