Provider Demographics
NPI:1215387287
Name:SANDRIDGE, ASHLEY (NP-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:SANDRIDGE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:5 HARRIS CT
Mailing Address - Street 2:BLDG T
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5750
Mailing Address - Country:US
Mailing Address - Phone:831-375-4105
Mailing Address - Fax:831-642-4097
Practice Address - Street 1:5 HARRIS CT BLDG T
Practice Address - Street 2:# 201
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940
Practice Address - Country:US
Practice Address - Phone:831-375-4105
Practice Address - Fax:831-372-5722
Is Sole Proprietor?:No
Enumeration Date:2016-06-20
Last Update Date:2018-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001229425163W00000X
VA0024173731363L00000X
CA95010565363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse