Provider Demographics
NPI:1912387721
Name:ZIMMER, REIA THERESA (RN, MSN, PNP-AC)
Entity Type:Individual
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First Name:REIA
Middle Name:THERESA
Last Name:ZIMMER
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Gender:F
Credentials:RN, MSN, PNP-AC
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Other - Middle Name:
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Mailing Address - Street 1:1855 4TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-2350
Mailing Address - Country:US
Mailing Address - Phone:800-793-3887
Mailing Address - Fax:415-502-0660
Practice Address - Street 1:1855 4TH ST FL 2
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158-2350
Practice Address - Country:US
Practice Address - Phone:800-793-3887
Practice Address - Fax:415-502-0660
Is Sole Proprietor?:No
Enumeration Date:2015-06-05
Last Update Date:2023-08-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CANP95001536363LP0200X
CA364SP0200X364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics