Provider Demographics
NPI:1023033164
Name:FOSTER, ASHLI MARIE (LAC)
Entity Type:Individual
Prefix:MRS
First Name:ASHLI
Middle Name:MARIE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:630 S GLASSELL ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-3004
Mailing Address - Country:US
Mailing Address - Phone:714-639-3935
Mailing Address - Fax:714-450-1029
Practice Address - Street 1:630 S GLASSELL ST
Practice Address - Street 2:SUITE 102
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-3004
Practice Address - Country:US
Practice Address - Phone:714-639-3935
Practice Address - Fax:714-450-1029
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC 10143171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist