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General NPI Number Information
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NPI Number | 1396953717
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Entity Type | Individual
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Provider Name | JEFFREY LESLIE ZIMMERMAN PH.D
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Gender | Male
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 21760 STEVENS CREEK BLVD 102
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City | CUPERTINO
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State | CA
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Zip | 95014-1170
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Country | US
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Telephone | 408-257-6882
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Fax | 408-257-0689
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Provider Business Mailing Address
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Address Line | 1 SAINT FRANCIS PL 6219
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City | SAN FRANCISCO
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State | CA
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Zip | 94107-1330
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Country | US
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Telephone | 415-222-9656
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY10760
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License Number State | CA
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