# MRS. MOON V TINAJERO-SIMMALY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1295330694
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 58655 | CA | — |
| 363A00000X | Physician Assistant | PA2358 | NV | — |
| 363A00000X | Physician Assistant | PA61511235 | WA | Yes |

## Other

- **Enumeration date:** 12/02/2020
- **Last updated:** 04/30/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1295330694 | — | NV |
| 01 | — | PA2358 | STATE LICENSE | NV |