Healthcare Provider Details

I. General information

NPI: 1184542466
Provider Name (Legal Business Name): ASHLEEN KAUSHAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 W WATKINS ST
PHOENIX AZ
85003-2830
US

IV. Provider business mailing address

625 N 2ND AVE APT 1008
PHOENIX AZ
85003-0148
US

V. Phone/Fax

Practice location:
  • Phone: 602-261-6825
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: