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NPI Code Detail

MEDICARE: DR. JEFFREY LESLIE ZIMMERMAN PH.D

MEDICARE:  DR. JEFFREY LESLIE ZIMMERMAN  PH.D
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
1103TC0700XClinical PsychologistPSY10760CA

General Provider Information

NPI Number : 1396953717
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY LESLIE ZIMMERMAN PH.D
Provider Business Mailing Address
First Line : 1 SAINT FRANCIS PL
Second Line : 6219
City : SAN FRANCISCO
State : CA
Zip : 94107-1330
Country : US
Telephone Number : 415-222-9656
Fax Number :
Provider Business Practice Location Address
First Line : 21760 STEVENS CREEK BLVD
Second Line : 102
City : CUPERTINO
State : CA
Zip : 95014-1170
Country : US
Telephone Number : 408-257-6882
Fax Number : 408-257-0689
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2007
Last Update Date : 07/08/2007

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Directions to “ DR. JEFFREY LESLIE ZIMMERMAN PH.D” Practice Location

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