Healthcare Provider Details

I. General information

NPI: 1164319869
Provider Name (Legal Business Name): ASHLEY REID
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11500 PARAMOUNT BLVD
DOWNEY CA
90241-4530
US

IV. Provider business mailing address

245 W 10TH ST APT 1
SAN PEDRO CA
90731-3700
US

V. Phone/Fax

Practice location:
  • Phone: 562-923-4545
  • Fax:
Mailing address:
  • Phone: 310-245-5740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: