Healthcare Provider Details

I. General information

NPI: 1558798769
Provider Name (Legal Business Name): MRS. ASHLEY LYNN PASCARELLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2013
Last Update Date: 12/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 N NORMA ST STE 127-133
RIDGECREST CA
93555-2575
US

IV. Provider business mailing address

1400 N NORMA ST STE 127-133
RIDGECREST CA
93555-2575
US

V. Phone/Fax

Practice location:
  • Phone: 760-499-7406
  • Fax: 760-499-7479
Mailing address:
  • Phone: 760-499-7406
  • Fax: 760-499-7479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: