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NPI Code Detail

MEDICARE: ASHLEY BUCKLEY

MEDICARE: ASHLEY BUCKLEY
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1861034746
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY BUCKLEY
Provider Business Mailing Address
First Line : 3550 CAMINO DEL RIO N STE 305
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-1740
Country : US
Telephone Number : 619-756-4095
Fax Number : 619-514-1026
Provider Business Practice Location Address
First Line : 3550 CAMINO DEL RIO N STE 305
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-1740
Country : US
Telephone Number : 619-756-4095
Fax Number : 619-514-1026
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2019
Last Update Date : 07/17/2023

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Directions to “ ASHLEY BUCKLEY ” Practice Location

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