Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LCS 19879 | CA |
NPI | 1003025693 |
---|---|
Provider Name | Sadaya Zimmerle |
First Address | San Leandro, CA 94578-1088 |
Second Address | San Leandro, CA 94578-1088 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 08/07/2007 |