Individual provider Active NPI

Jennifer Marie Simmons, LMFT

  • Marriage & Family Therapist
  • Riverside, CA
National Provider Identifier
1972076057
Registry record updated Jan 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
34926 Issued in CA
Practice address
3894 Jurupa Ave
Riverside, CA 92506-2222
Phone
(951) 369-9990
Fax
(951) 369-9090
NPI assigned
Jan 10, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 34926 CA Primary

Addresses

Primary practice location

3894 Jurupa Ave
Riverside, CA 92506-2222

Mailing address

3894 Jurupa Ave
Riverside, CA 92506-2222
Phone (951) 369-9990

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
34926CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychotherapy & Family Court Services Marriage & Family Therapist PastSince May 29, 2022 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1972076057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3894 JURUPA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062222",
            "telephone_number": "951-369-9990",
            "fax_number": "951-369-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3894 JURUPA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062222",
            "telephone_number": "951-369-9990",
            "fax_number": "951-369-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-10",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "34926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; 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.