Healthcare Provider Details

I. General information

NPI: 1629265996
Provider Name (Legal Business Name): MISS ASHLEY ANN OWLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2007
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 COYLE AVE STE A
CARMICHAEL CA
95608-0400
US

IV. Provider business mailing address

4621 S HILLS DR
FOLSOM CA
95630-6000
US

V. Phone/Fax

Practice location:
  • Phone: 916-414-9055
  • Fax: 916-414-9054
Mailing address:
  • Phone: 510-219-8883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95037487
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: