Healthcare Provider Details

I. General information

NPI: 1831465137
Provider Name (Legal Business Name): ANGELICA LYNN ASHLEY LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2012
Last Update Date: 03/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 SAVIERS RD # 10
OXNARD CA
93033-3608
US

IV. Provider business mailing address

628 GREEN RIVER ST
OXNARD CA
93036-5318
US

V. Phone/Fax

Practice location:
  • Phone: 805-483-2253
  • Fax:
Mailing address:
  • Phone: 805-208-2243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberVN 220652
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: