Healthcare Provider Details

I. General information

NPI: 1548802499
Provider Name (Legal Business Name): ERIN ELISSA ASHLEY LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2019
Last Update Date: 11/17/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4251 S HIGUERA ST STE 300
SAN LUIS OBISPO CA
93401-7741
US

IV. Provider business mailing address

4251 S HIGUERA ST STE 300
SAN LUIS OBISPO CA
93401-7741
US

V. Phone/Fax

Practice location:
  • Phone: 805-270-4466
  • Fax: 805-855-4014
Mailing address:
  • Phone: 805-270-4466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberLM601
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: