Healthcare Provider Details

I. General information

NPI: 1336863976
Provider Name (Legal Business Name): ASHLEY LYNN HUA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2022
Last Update Date: 09/28/2022
Certification Date: 09/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

729 FILBERT ST
SAN FRANCISCO CA
94133-2760
US

IV. Provider business mailing address

231 KIRKHAM ST
SAN FRANCISCO CA
94122-3818
US

V. Phone/Fax

Practice location:
  • Phone: 415-352-2000
  • Fax:
Mailing address:
  • Phone: 714-376-7265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number46736
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: