Healthcare Provider Details

I. General information

NPI: 1487310876
Provider Name (Legal Business Name): ASHLEY PERKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2021
Last Update Date: 11/10/2021
Certification Date: 11/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 EMERSON ST
CHULA VISTA CA
91911-3309
US

IV. Provider business mailing address

430 F ST
CHULA VISTA CA
91910-3711
US

V. Phone/Fax

Practice location:
  • Phone: 619-517-4642
  • Fax:
Mailing address:
  • Phone: 619-517-4642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: