=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508664087
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ASHLEY ANGEL PPS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/03/2025
-----------------------------------------------------
Last Update Date | 03/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 450 W EAST AVE
-----------------------------------------------------
City | CHICO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95926-7238
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-879-7483
-----------------------------------------------------
Fax | 530-879-7490
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 450 W EAST AVE
-----------------------------------------------------
City | CHICO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95926-7238
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 308-797-4835
-----------------------------------------------------
Fax | 530-879-7490
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YS0200X
-----------------------------------------------------
Taxonomy Name | School Counselor
-----------------------------------------------------
License Number | 220231158
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------