Healthcare Provider Details

I. General information

NPI: 1972440139
Provider Name (Legal Business Name): MRS. ASHLEY R HINESLEY CAMPOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13525 CIELO AZUL WAY
DESERT HOT SPRINGS CA
92240-6235
US

IV. Provider business mailing address

67720 OVANTE RD
CATHEDRAL CITY CA
92234-5534
US

V. Phone/Fax

Practice location:
  • Phone: 760-329-4673
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberA050210818
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: