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NPI Code Detail

MEDICARE: MS. ASHLEY LIGHT LMFT 169082

MEDICARE: MS. ASHLEY LIGHT LMFT 169082
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
1106H00000XMarriage & Family Therapist160982CA

General Provider Information

NPI Number : 1245095611
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ASHLEY LIGHT LMFT 169082
Provider Business Mailing Address
First Line : PO BOX 26001
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92406-0701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 20 W LUGONIA AVE
Second Line :
City : REDLANDS
State : CA
Zip : 92374-2234
Country : US
Telephone Number : 909-389-2750
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2024
Last Update Date : 01/20/2026

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