MEDICARE: ASHLEY BALL

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	106H00000X	Marriage & Family Therapist	81825	CA

General Provider Information

NPI Number	:	1265160576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY BALL

Provider Business Mailing Address
First Line	:	928 BAYPOINTE DR
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-8510
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	928 BAYPOINTE DR
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-8510
Country	:	US
Telephone Number	:	949-701-0822
Fax Number	:

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

Provider Enumeration Date	:	08/13/2022
Last Update Date	:	08/13/2022

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Directions to “ ASHLEY BALL ” Practice Location

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