MEDICARE: DENISE ASHLIN LCSW

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
1	1041C0700X	Clinical Social Worker	93814	CA

General Provider Information

NPI Number	:	1871828749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE ASHLIN LCSW

Provider Business Mailing Address
First Line	:	PO BOX 582941
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95758-0050
Country	:	US
Telephone Number	:	209-200-7582
Fax Number	:

Provider Business Practice Location Address
First Line	:	10141 VAN BROCKLIN WAY
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95757-2518
Country	:	US
Telephone Number	:	209-200-7582
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2009
Last Update Date	:	09/29/2020

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