Healthcare Provider Details

I. General information

NPI: 1639093438
Provider Name (Legal Business Name): ASHLEY BISHOP M.A. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5538 W 142ND PL
HAWTHORNE CA
90250-6634
US

IV. Provider business mailing address

5538 W 142ND PL
HAWTHORNE CA
90250-6634
US

V. Phone/Fax

Practice location:
  • Phone: 619-886-8651
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number19777
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: