Provider Demographics
NPI:1194178087
Name:HIGMAN, ZOE KODA
Entity Type:Individual
Prefix:
First Name:ZOE
Middle Name:KODA
Last Name:HIGMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3270 RIO RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-9000
Mailing Address - Country:US
Mailing Address - Phone:831-238-7461
Mailing Address - Fax:
Practice Address - Street 1:1630 E BULLDOG LANE
Practice Address - Street 2:MEYERS FAMILY SPORTS MEDICINE CENTER
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93740
Practice Address - Country:US
Practice Address - Phone:559-278-4170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer