Active NPI
Jeffrey Leslie Zimmerman, PH.D
- Clinical Psychologist
- Cupertino, CA
National Provider Identifier
1396953717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY10760
- Practice address
- 21760 Stevens Creek Blvd
102
Cupertino, CA 95014-1170 - Phone
- (408) 257-6882
- Fax
- (408) 257-0689
- NPI assigned
- May 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY10760 | CA | Primary |
Addresses
Primary practice location
21760 Stevens Creek Blvd
102
Cupertino, CA 95014-1170
Mailing address
1 Saint Francis PL
6219
San Francisco, CA 94107-1330
Phone (415) 222-9656
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY10760 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396953717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 SAINT FRANCIS PL",
"address_2": "6219",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941071330",
"telephone_number": "415-222-9656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21760 STEVENS CREEK BLVD",
"address_2": "102",
"city": "CUPERTINO",
"state": "CA",
"postal_code": "950141170",
"telephone_number": "408-257-6882",
"fax_number": "408-257-0689"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIMMERMAN",
"first_name": "JEFFREY",
"middle_name": "LESLIE",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY10760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cupertino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.