Provider Demographics
NPI:1154341006
Name:ZIMBARDI, ANTHONY JOHN JR (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JOHN
Last Name:ZIMBARDI
Suffix:JR
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3121 ELLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90068-1738
Mailing Address - Country:US
Mailing Address - Phone:323-351-4531
Mailing Address - Fax:323-848-9974
Practice Address - Street 1:8235 SANTA MONICA BLVD
Practice Address - Street 2:PENTHOUSE SUITE
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-5914
Practice Address - Country:US
Practice Address - Phone:323-851-1304
Practice Address - Fax:323-848-9974
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33579106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist