MEDICARE: CHARISSA ZIMA

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	363L00000X	Nurse Practitioner	95029980	CA

General Provider Information

NPI Number	:	1831987965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARISSA ZIMA

Provider Business Mailing Address
First Line	:	3047 CANYON VISTA DR
Second Line	:
City	:	COLTON
State	:	CA
Zip	:	92324-9791
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3047 CANYON VISTA DR
Second Line	:
City	:	COLTON
State	:	CA
Zip	:	92324-9791
Country	:	US
Telephone Number	:	909-254-8586
Fax Number	:

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

Provider Enumeration Date	:	04/29/2025
Last Update Date	:	06/04/2026

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Directions to “ CHARISSA ZIMA ” Practice Location

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