Provider Demographics
NPI:1285487629
Name:ZALDANA, KENNY (DPT)
Entity type:Individual
Prefix:DR
First Name:KENNY
Middle Name:
Last Name:ZALDANA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2326 DONAHUE AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-6700
Mailing Address - Country:US
Mailing Address - Phone:707-326-6265
Mailing Address - Fax:
Practice Address - Street 1:2798 YULUPA AVE STE A
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-8570
Practice Address - Country:US
Practice Address - Phone:707-527-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA305657208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation