Healthcare Provider Details

I. General information

NPI: 1619625340
Provider Name (Legal Business Name): ASHLEY DARGERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2022
Last Update Date: 03/28/2022
Certification Date: 03/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9015 MURRAY AVE STE 100
GILROY CA
95020-3675
US

IV. Provider business mailing address

9015 MURRAY AVE STE 100
GILROY CA
95020-3675
US

V. Phone/Fax

Practice location:
  • Phone: 408-842-7138
  • Fax:
Mailing address:
  • Phone: 408-842-7138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: