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Individual
DR. NATHAN KYLE SIMMONS
Active
Individual
DR. NATHAN KYLE SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
103TC0700X
Clinical Psychologist
PSY25856
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W416
PCSD MEDICARE #
CA
Enumeration date
12/18/2006
Last updated
04/17/2019
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