Provider Demographics
NPI:1669638284
Name:ZIMBLEMAN, COLIN ROSS
Entity Type:Individual
Prefix:MR
First Name:COLIN
Middle Name:ROSS
Last Name:ZIMBLEMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3519 PADARO LN
Mailing Address - Street 2:
Mailing Address - City:CARPINTERIA
Mailing Address - State:CA
Mailing Address - Zip Code:93013-1119
Mailing Address - Country:US
Mailing Address - Phone:805-453-3311
Mailing Address - Fax:
Practice Address - Street 1:72 MOODY CT
Practice Address - Street 2:2ND FLOOR
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-6067
Practice Address - Country:US
Practice Address - Phone:805-777-3542
Practice Address - Fax:805-777-3515
Is Sole Proprietor?:No
Enumeration Date:2008-08-03
Last Update Date:2008-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist