Provider Demographics
NPI:1578634093
Name:SIMMONS, IAN JAMES
Entity type:Individual
Prefix:
First Name:IAN
Middle Name:JAMES
Last Name:SIMMONS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 W CARRILLO ST
Mailing Address - Street 2:#126
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-3710
Mailing Address - Country:US
Mailing Address - Phone:805-886-5396
Mailing Address - Fax:
Practice Address - Street 1:315 W HALEY ST
Practice Address - Street 2:#102
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-3471
Practice Address - Country:US
Practice Address - Phone:805-966-3310
Practice Address - Fax:805-966-5582
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health