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NPI Code Detail

MEDICARE: ASHLEY SERVEN MS, ATC

MEDICARE: ASHLEY SERVEN MS, ATC
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
12255A2300XAthletic Trainer

General Provider Information

NPI Number : 1952095416
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY SERVEN MS, ATC
Provider Business Mailing Address
First Line : 435 BAY MEADOWS WAY
Second Line :
City : SOLANA BEACH
State : CA
Zip : 92075-2447
Country : US
Telephone Number : 858-442-1434
Fax Number :
Provider Business Practice Location Address
First Line : 5500 CAMPANILE DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92182-0003
Country : US
Telephone Number : 858-442-1434
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2023
Last Update Date : 12/14/2025

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