Provider Demographics
NPI:1386051001
Name:ZIMMER-VARGAS, MONICA (ATC)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:ZIMMER-VARGAS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7213 OLD NAVE CT
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95842-1732
Mailing Address - Country:US
Mailing Address - Phone:916-396-4386
Mailing Address - Fax:
Practice Address - Street 1:333 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-3707
Practice Address - Country:US
Practice Address - Phone:916-577-2368
Practice Address - Fax:916-577-2360
Is Sole Proprietor?:No
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer