Provider Demographics
NPI:1679639223
Name:SIMMONDS, ADRIENNE (MA)
Entity type:Individual
Prefix:MISS
First Name:ADRIENNE
Middle Name:
Last Name:SIMMONDS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5724 W 3RD ST
Mailing Address - Street 2:STE #307
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036
Mailing Address - Country:US
Mailing Address - Phone:760-670-5166
Mailing Address - Fax:
Practice Address - Street 1:5724 W 3RD ST
Practice Address - Street 2:STE #307
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036
Practice Address - Country:US
Practice Address - Phone:760-670-5166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health