Healthcare Provider Details

I. General information

NPI: 1639733280
Provider Name (Legal Business Name): ASHLEY HUGH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2019
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 LARKSPUR LANDING CIR STE 10
LARKSPUR CA
94939-1836
US

IV. Provider business mailing address

600 S PAULINA ST STE 403
CHICAGO IL
60612-3806
US

V. Phone/Fax

Practice location:
  • Phone: 415-925-8070
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA191866
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: