Healthcare Provider Details

I. General information

NPI: 1154259661
Provider Name (Legal Business Name): MARIA NOEL ZIMMERMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 STEVENSON ST
SAN FRANCISCO CA
94103-1606
US

IV. Provider business mailing address

555 STEVENSON ST
SAN FRANCISCO CA
94103-1606
US

V. Phone/Fax

Practice location:
  • Phone: 628-217-5800
  • Fax: 628-217-7501
Mailing address:
  • Phone: 628-217-5800
  • Fax: 628-217-7501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95041779
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number95041779
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number95041779
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: