Provider Demographics
NPI:1003481243
Name:PICKARD, ASHLEY AMY MAY (RAC)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:AMY MAY
Last Name:PICKARD
Suffix:
Gender:F
Credentials:RAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 N F ST
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-6033
Mailing Address - Country:US
Mailing Address - Phone:805-735-7525
Mailing Address - Fax:
Practice Address - Street 1:133 N F ST
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-6033
Practice Address - Country:US
Practice Address - Phone:805-735-7525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)