Active NPI
Holli Jo Zandona, LCSW
- Clinical Social Worker
- Fair Oaks, CA
National Provider Identifier
1851466296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 26703
- Practice address
- 9712 Fair Oaks Blvd Ste A1
Fair Oaks, CA 95628-7032 - Phone
- (279) 321-1555
- NPI assigned
- Nov 21, 2006
- Sex
- Female
- 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 Social Worker | 1041C0700X | 26703 | CA | Primary |
Addresses
Primary practice location
9712 Fair Oaks Blvd Ste A1
Fair Oaks, CA 95628-7032
Mailing address
9712 Fair Oaks Blvd Ste a-1
Fair Oaks, CA 95628-7032
Phone (279) 321-1555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 30, 2024 through Jan 30, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26703 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706227200000",
"number": "1851466296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9712 FAIR OAKS BLVD STE A-1",
"city": "FAIR OAKS",
"state": "CA",
"postal_code": "956287032",
"telephone_number": "279-321-1555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9712 FAIR OAKS BLVD STE A1",
"city": "FAIR OAKS",
"state": "CA",
"postal_code": "956287032",
"telephone_number": "279-321-1555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZANDONA",
"first_name": "HOLLI",
"middle_name": "JO",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-21",
"last_updated": "2024-01-26",
"certification_date": "2024-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "26703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fair Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.