Provider Demographics
NPI:1962689166
Name:NIMMER, CAROLINA (CMT)
Entity Type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:NIMMER
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 WALTHAM RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-3417
Mailing Address - Country:US
Mailing Address - Phone:925-457-4493
Mailing Address - Fax:
Practice Address - Street 1:2001 SALVIO ST # 26B
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2495
Practice Address - Country:US
Practice Address - Phone:925-457-4493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist