Healthcare Provider Details

I. General information

NPI: 1215476049
Provider Name (Legal Business Name): ASHLEIGH GAULKE D.P.T
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2017
Last Update Date: 06/02/2020
Certification Date: 06/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 K ST SUITE 170
SACRAMENTO CA
95816-5124
US

IV. Provider business mailing address

10390 COLOMA RD STE 7
RANCHO CORDOVA CA
95670-2152
US

V. Phone/Fax

Practice location:
  • Phone: 916-220-5559
  • Fax:
Mailing address:
  • Phone: 916-858-0950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT292746
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: