Healthcare Provider Details

I. General information

NPI: 1205774478
Provider Name (Legal Business Name): MS. ASHLEY LYNN MCGRAW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8864 11TH AVE
HESPERIA CA
92345-3842
US

IV. Provider business mailing address

8864 11TH AVE
HESPERIA CA
92345-3842
US

V. Phone/Fax

Practice location:
  • Phone: 760-983-1113
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95214137
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: