Provider Demographics
NPI:1265833123
Name:HALL, ASPEN
Entity Type:Individual
Prefix:
First Name:ASPEN
Middle Name:
Last Name:HALL
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 1:9719 LINCOLN VILLAGE DR
Mailing Address - Street 2:300
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-3303
Mailing Address - Country:US
Mailing Address - Phone:916-485-4175
Mailing Address - Fax:916-480-2241
Practice Address - Street 1:9719 LINCOLN VILLAGE DR
Practice Address - Street 2:300
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-3303
Practice Address - Country:US
Practice Address - Phone:916-485-4175
Practice Address - Fax:916-480-2241
Is Sole Proprietor?:No
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program