Provider Demographics
NPI:1386533586
Name:KONING, ASHLEY NICOLE (MS SLP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICOLE
Last Name:KONING
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:NICOLE
Other - Last Name:SANDAHL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS SLP
Mailing Address - Street 1:4317 SAND CANYON RD
Mailing Address - Street 2:
Mailing Address - City:SOMIS
Mailing Address - State:CA
Mailing Address - Zip Code:93066-9750
Mailing Address - Country:US
Mailing Address - Phone:805-624-2399
Mailing Address - Fax:
Practice Address - Street 1:400 W VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-9137
Practice Address - Country:US
Practice Address - Phone:805-383-1497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39782235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist