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General NPI Number Information
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NPI Number | 1316183908
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Entity Type | Individual
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Provider Name | MARY ANN ZIMMERMAN
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Gender | Female
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Dates
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Enumeration Date | 01/02/2009
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Last Update Date | 01/02/2009
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Provider Practice Location Address
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Address Line | 13800 HEACOCK ST. STE. C236
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City | MORENO VALLEY
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State | CA
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Zip | 92553
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Country | US
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Telephone | 951-653-0819
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Fax |
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Provider Business Mailing Address
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Address Line | 79165 VICTORIA DR.
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City | LA QUINTA
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State | CA
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Zip | 92253
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Country | US
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Telephone | 760-485-8516
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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