Healthcare Provider Details

I. General information

NPI: 1932968294
Provider Name (Legal Business Name): ASHLEY BROOKSBANK COLBURN APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 01/11/2026
Certification Date: 01/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 W CREST ST STE 210
ESCONDIDO CA
92025-1739
US

IV. Provider business mailing address

221 W CREST ST STE 210
ESCONDIDO CA
92025-1739
US

V. Phone/Fax

Practice location:
  • Phone: 760-747-3424
  • Fax:
Mailing address:
  • Phone: 760-747-3424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number15764
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: