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NPI Code Detail

MEDICARE: ASHLEY STANFORD PMHNP

MEDICARE: ASHLEY STANFORD PMHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN95356790CA
2363LP0808XPsychiatric/Mental Health Nurse Practitioner2026018168CA

General Provider Information

NPI Number : 1205603420
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY STANFORD PMHNP
Provider Business Mailing Address
First Line : 5635 VANDEN RD
Second Line :
City : VACAVILLE
State : CA
Zip : 95687-8295
Country : US
Telephone Number : 850-454-4443
Fax Number :
Provider Business Practice Location Address
First Line : 2101 COURAGE DR
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-6717
Country : US
Telephone Number : 707-428-1131
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2023
Last Update Date : 04/07/2026

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