Provider Demographics
NPI:1245121458
Name:ZANDONA, MICHAEL G (AUD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:G
Last Name:ZANDONA
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 W HILLCREST DR STE 100
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-7820
Mailing Address - Country:US
Mailing Address - Phone:805-379-0824
Mailing Address - Fax:
Practice Address - Street 1:299 W HILLCREST DR STE 100
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-7820
Practice Address - Country:US
Practice Address - Phone:805-379-0824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU4031231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist