Healthcare Provider Details

I. General information

NPI: 1083478275
Provider Name (Legal Business Name): ERIKA TORRES ZIMMER LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2024
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10201 MISSION GORGE RD STE O
SANTEE CA
92071-3040
US

IV. Provider business mailing address

3477 MONIQUE LN
SPRING VALLEY CA
91977-2883
US

V. Phone/Fax

Practice location:
  • Phone: 619-383-6868
  • Fax: 619-330-2760
Mailing address:
  • Phone: 760-208-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number204256
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: