Healthcare Provider Details

I. General information

NPI: 1598698839
Provider Name (Legal Business Name): ASHLEY CHARRON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2781 W RAMSEY ST
BANNING CA
92220-3700
US

IV. Provider business mailing address

1348 ROCKCRESS LN
BANNING CA
92220-1298
US

V. Phone/Fax

Practice location:
  • Phone: 951-417-6612
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number288336
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: