Basic Information
| Provider Information | |||||||||
| NPI: | 1538548904 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SIMPSON | ||||||||
| FirstName: | JEAN | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | FONSECA, WONG | ||||||||
| OtherFirstName: | JEAN | ||||||||
| OtherMiddleName: | BING | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | JD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1542 TULANE AVE | ||||||||
| Address2: | ROOM 231 | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701122865 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5045686004 | ||||||||
| FaxNumber: | 5045686006 | ||||||||
| Practice Location | |||||||||
| Address1: | 1542 TULANE AVE | ||||||||
| Address2: | ROOM 231 | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701122865 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5045686004 | ||||||||
| FaxNumber: | 5045686006 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2015 | ||||||||
| LastUpdateDate: | 06/10/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 05/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | PGY.202860 | LA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.