Simon, Robert Alexander

Simon, Robert Alexander is an sole proprietor health care provider with primary practice located at 3636 4Th Ave Suite 210, San Diego CA 92103-4280. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Forensic. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Simon, Robert Alexander can be contacted via phone (619) 220-7680.

Contact Information

Primary practice address
3636 4Th Ave Suite 210 San Diego CA 92103-4280
Phone: (619) 220-7680
Fax: (619) 220-7682
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY10800 California
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X PSY10800 California
Behavioral Health & Social Service Providers / Forensic 103TF0200X PSY10800 California

Profile Details

NPI number 1245251073
LBN Legal business name Simon, Robert Alexander
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 21st, 2006
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245251073 NPPES
California MEDICAID PSY108000

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