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General NPI Number Information
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NPI Number | 1821839630
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Entity Type | Individual
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Provider Name | ASHLEY NICOLE BUTLER RD, CEDS-C
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Gender | Female
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 07/27/2026
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Provider Practice Location Address
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Address Line | 919 FREMONT AVE STE 100
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City | LOS ALTOS
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State | CA
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Zip | 94024-6047
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Country | US
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Telephone | 650-671-1462
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Fax |
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Provider Business Mailing Address
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Address Line | 975 MILLS CT
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City | SAN JOSE
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State | CA
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Zip | 95125-1653
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Country | US
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Telephone | 970-217-7150
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 86167158
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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