Provider Demographics
NPI:1841330529
Name:INTARA ZIM, JOANNA CLAIRE (MA, LMFT)
Entity type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:CLAIRE
Last Name:INTARA ZIM
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2282 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-3902
Mailing Address - Country:US
Mailing Address - Phone:415-923-0481
Mailing Address - Fax:707-778-8697
Practice Address - Street 1:2282 UNION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-3902
Practice Address - Country:US
Practice Address - Phone:415-923-0481
Practice Address - Fax:707-778-8697
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38453106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist