Provider Demographics
NPI:1083277875
Name:BABCOCK, ASHLEY (RN, NP STUDENT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BABCOCK
Suffix:
Gender:F
Credentials:RN, NP STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2229 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-1734
Mailing Address - Country:US
Mailing Address - Phone:818-400-1651
Mailing Address - Fax:
Practice Address - Street 1:2229 28TH AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94116-1734
Practice Address - Country:US
Practice Address - Phone:818-400-1651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-17
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016091363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily