Provider Demographics
NPI:1093480923
Name:ABARCA, ASHLEY JULEANA
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:JULEANA
Last Name:ABARCA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 VINELAND AVE APT 105
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-4544
Mailing Address - Country:US
Mailing Address - Phone:818-423-3882
Mailing Address - Fax:
Practice Address - Street 1:7700 VINELAND AVE APT 105
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-4544
Practice Address - Country:US
Practice Address - Phone:818-423-3882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician