MEDICARE: MADELEINE E ZIMMERMAN LCSW

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	104100000X	Social Worker	115843	CA

General Provider Information

NPI Number	:	1346982196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADELEINE E ZIMMERMAN LCSW

Provider Business Mailing Address
First Line	:	8605 SANTA MONICA BLVD PMB 231540
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90069
Country	:	US
Telephone Number	:	805-292-0649
Fax Number	:

Provider Business Practice Location Address
First Line	:	1342 10TH ST
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90401-1933
Country	:	US
Telephone Number	:	213-255-9267
Fax Number	:

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

Provider Enumeration Date	:	04/12/2022
Last Update Date	:	03/29/2024

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