MEDICARE: DR. JENNIFER PAIGE ZIMMERMANN DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT32813	CA

General Provider Information

NPI Number	:	1205887593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER PAIGE ZIMMERMANN DPT

Provider Business Mailing Address
First Line	:	303 ARLINGTON AVE
Second Line	:
City	:	KENSINGTON
State	:	CA
Zip	:	94707-1600
Country	:	US
Telephone Number	:	510-527-7737
Fax Number	:	510-527-7738

Provider Business Practice Location Address
First Line	:	303 ARLINGTON AVE
Second Line	:
City	:	KENSINGTON
State	:	CA
Zip	:	94707-1600
Country	:	US
Telephone Number	:	510-527-7737
Fax Number	:	510-527-7738

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	07/08/2007

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