Provider Demographics
NPI:1063851814
Name:CRUZ, ASHLEY DENISE (MSPAS, MPH, PA-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:DENISE
Last Name:CRUZ
Suffix:
Gender:F
Credentials:MSPAS, MPH, PA-C
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:DENISE
Other - Last Name:MULLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3415 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-3648
Mailing Address - Country:US
Mailing Address - Phone:916-737-5555
Mailing Address - Fax:
Practice Address - Street 1:3415 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-3648
Practice Address - Country:US
Practice Address - Phone:916-737-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22997363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA22997OtherPA LICENSE