Individual
YVONNE DECARLO SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3022 FRANKLIN AVE, SAN DIEGO, CA 92113-1415
(619) 709-7817
Mailing address
3022 FRANKLIN AVE, SAN DIEGO, CA 92113-1415
(619) 709-7817
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B9238015
DRIVER LICENSE
CA
Enumeration date
11/19/2019
Last updated
11/19/2019
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