Healthcare Provider Details

I. General information

NPI: 1144791229
Provider Name (Legal Business Name): ASHLEY ROCHELLE BALLETTO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY ROCHELLE WELKER

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 E STANDLEY ST
UKIAH CA
95482-4414
US

IV. Provider business mailing address

280 E STANDLEY ST
UKIAH CA
95482-4414
US

V. Phone/Fax

Practice location:
  • Phone: 707-466-0001
  • Fax:
Mailing address:
  • Phone: 707-466-0001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95041352
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: