Provider Demographics
NPI:1861549008
Name:ZIMMERMAN, DONA CAROL (PHD)
Entity type:Individual
Prefix:DR
First Name:DONA
Middle Name:CAROL
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2213 BUCHANAN ROAD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509
Mailing Address - Country:US
Mailing Address - Phone:925-779-4961
Mailing Address - Fax:925-779-4963
Practice Address - Street 1:2213 BUCHANAN ROAD
Practice Address - Street 2:SUITE 203
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509
Practice Address - Country:US
Practice Address - Phone:925-779-4961
Practice Address - Fax:925-779-4963
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY 14862103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY 14862OtherPSYCHOLOGY LICENSE