MEDICARE: ASHLEY ZACHERY-SAVELLA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1043030844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY ZACHERY-SAVELLA

Provider Business Mailing Address
First Line	:	50 N MEDICAL DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84132-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6482 AMBROSIA DR APT 5208
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92124-3143
Country	:	US
Telephone Number	:	443-694-0397
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2024
Last Update Date	:	11/04/2024

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Directions to “ ASHLEY ZACHERY-SAVELLA ” Practice Location

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