Provider Demographics
NPI:1326440579
Name:PERREIRA, ASHLEY
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:PERREIRA
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 1:6011 N FRESNO ST
Mailing Address - Street 2:STE 115
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5274
Mailing Address - Country:US
Mailing Address - Phone:559-438-2745
Mailing Address - Fax:559-438-2746
Practice Address - Street 1:6011 N FRESNO ST
Practice Address - Street 2:STE 115
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5274
Practice Address - Country:US
Practice Address - Phone:559-438-2745
Practice Address - Fax:559-438-2746
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist