1033259056 NPI number — MRS. CHRISTINA HEARTT ZIMMERMAN MFTI

Table of content: MRS. CHRISTINA HEARTT ZIMMERMAN MFTI (NPI 1033259056)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033259056 NPI number — MRS. CHRISTINA HEARTT ZIMMERMAN MFTI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZIMMERMAN
Provider First Name:
CHRISTINA
Provider Middle Name:
HEARTT
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MFTI
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
THOMAS
Provider Other First Name:
CHRISTINA
Provider Other Middle Name:
HEARTT
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1033259056
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
242 N VILLA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLOWS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95988-2641
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
530-934-6582
Provider Business Mailing Address Fax Number:
530-934-6592

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
242 N VILLA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILLOWS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95988-2641
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-934-6582
Provider Business Practice Location Address Fax Number:
530-934-6592
Provider Enumeration Date:
02/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  50652 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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