Provider Demographics
NPI:1568077170
Name:SIMS, STEFFANIE (MS, BCBA)
Entity type:Individual
Prefix:
First Name:STEFFANIE
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 E ARNAUDO BLVD APT 1133
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOUSE
Mailing Address - State:CA
Mailing Address - Zip Code:95391-8447
Mailing Address - Country:US
Mailing Address - Phone:209-640-2182
Mailing Address - Fax:
Practice Address - Street 1:111 DEERWOOD RD STE 115
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4445
Practice Address - Country:US
Practice Address - Phone:949-325-4402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-24-78121103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst