Healthcare Provider Details

I. General information

NPI: 1669762092
Provider Name (Legal Business Name): ASHLEY KAY RAMBEAU MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2011
Last Update Date: 04/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3665 KEARNY VILLA RD
SAN DIEGO CA
92123-1953
US

IV. Provider business mailing address

3020 CHILDRENS WAY # MC5016
SAN DIEGO CA
92123-4223
US

V. Phone/Fax

Practice location:
  • Phone: 858-576-1700
  • Fax: 858-966-5992
Mailing address:
  • Phone: 858-576-1700
  • Fax: 858-966-5992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberPENDING
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: