Healthcare Provider Details

I. General information

NPI: 1164064937
Provider Name (Legal Business Name): ASHTON RENEE PERRONI ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2019
Last Update Date: 10/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 DONDEE ST
PACIFICA CA
94044-3056
US

IV. Provider business mailing address

1382 UNION ST
SAN FRANCISCO CA
94109-1935
US

V. Phone/Fax

Practice location:
  • Phone: 650-380-0089
  • Fax:
Mailing address:
  • Phone: 805-405-7181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND1100
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: