Individual
MS. JENNIFER LEE ZIMMERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
1441 FLORIDA AVE., MODESTO, CA 95352
(209) 578-1211
Mailing address
1441 FLORIDA AVE, MODESTO, CA 95350-4404
(209) 576-3601
(209) 576-3680
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA10924
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CD069A
GROUP PTAN-GREATER MODESTO MEDICAL SURGICAL ASSOCIATES
CA
Enumeration date
10/03/2006
Last updated
03/28/2016
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