Provider Demographics
NPI:1003025693
Name:ZIMMERLE, SADAYA (LCSW, MSW)
Entity Type:Individual
Prefix:
First Name:SADAYA
Middle Name:
Last Name:ZIMMERLE
Suffix:
Gender:F
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 FAIRMONT DR
Mailing Address - Street 2:EDEN CSC
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-1088
Mailing Address - Country:US
Mailing Address - Phone:510-667-3913
Mailing Address - Fax:510-667-7711
Practice Address - Street 1:2045 FAIRMONT DR
Practice Address - Street 2:EDEN CSC
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-1088
Practice Address - Country:US
Practice Address - Phone:510-667-3913
Practice Address - Fax:510-667-7711
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 198791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical