Healthcare Provider Details

I. General information

NPI: 1689297475
Provider Name (Legal Business Name): ZIMMERMAN THERAPY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2020
Last Update Date: 10/04/2022
Certification Date: 01/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

644 POLLASKY AVE STE 203
CLOVIS CA
93612-1883
US

IV. Provider business mailing address

644 POLLASKY AVE STE 203
CLOVIS CA
93612-1883
US

V. Phone/Fax

Practice location:
  • Phone: 559-387-4123
  • Fax:
Mailing address:
  • Phone: 559-387-4123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE ZIMMERMAN
Title or Position: CEO
Credential: LMFT
Phone: 559-312-7779