MEDICARE: CYNTHIA L ZIMMERMAN C/OTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	3668	CA

General Provider Information

NPI Number	:	1275326399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA L ZIMMERMAN C/OTA

Provider Business Mailing Address
First Line	:	9405 SEDGEFIELD AVE
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95624-5092
Country	:	US
Telephone Number	:	330-631-4497
Fax Number	:

Provider Business Practice Location Address
First Line	:	9405 SEDGEFIELD AVE
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95624-5092
Country	:	US
Telephone Number	:	330-631-4497
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2025
Last Update Date	:	05/22/2025

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