Provider Demographics
NPI:1184849374
Name:ZIMMERMAN, BATYA BLOISE (MFT)
Entity Type:Individual
Prefix:MRS
First Name:BATYA
Middle Name:BLOISE
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6255 PISCES ST
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-1729
Mailing Address - Country:US
Mailing Address - Phone:818-371-1954
Mailing Address - Fax:818-889-7903
Practice Address - Street 1:5923 KANAN RD
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-1688
Practice Address - Country:US
Practice Address - Phone:818-371-1954
Practice Address - Fax:818-889-7903
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT35943106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist