Healthcare Provider Details

I. General information

NPI: 1265332977
Provider Name (Legal Business Name): ASHBY LAURA ANAYA CPT 1
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2026
Last Update Date: 11/06/2026
Certification Date: 11/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3312 S CARPENTER RD
MODESTO CA
95358-9674
US

IV. Provider business mailing address

3312 S CARPENTER RD
MODESTO CA
95358-9674
US

V. Phone/Fax

Practice location:
  • Phone: 209-345-1981
  • Fax:
Mailing address:
  • Phone: 209-345-1981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number12600354
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: