Healthcare Provider Details

I. General information

NPI: 1932414331
Provider Name (Legal Business Name): ASHLEY ERIKA JIMENEZ-ARREDONDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY ERIKA ANDERSON

II. Dates (important events)

Enumeration Date: 08/11/2010
Last Update Date: 05/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21030 MISSION ST
TEHACHAPI CA
93561-6769
US

IV. Provider business mailing address

23281 LAKEVIEW DR
TEHACHAPI CA
93561-7227
US

V. Phone/Fax

Practice location:
  • Phone: 858-334-5502
  • Fax:
Mailing address:
  • Phone: 858-334-5502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number86039
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: