Provider Demographics
NPI:1972263937
Name:FLEDZINSKAS, JON (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:
Last Name:FLEDZINSKAS
Suffix:
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 1:1689 OLIVEBROOK WALK
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-4072
Mailing Address - Country:US
Mailing Address - Phone:805-558-3473
Mailing Address - Fax:
Practice Address - Street 1:699 HAMPSHIRE RD STE 200
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2352
Practice Address - Country:US
Practice Address - Phone:805-702-0816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-17
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33071103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist