Provider Demographics
NPI:1366858821
Name:LYMAN, ASHLEIGH ANN (DPT)
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:ANN
Last Name:LYMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 PENNY LN
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-6010
Mailing Address - Country:US
Mailing Address - Phone:808-938-6525
Mailing Address - Fax:
Practice Address - Street 1:15 PENNY LN
Practice Address - Street 2:SUITE 4
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-6010
Practice Address - Country:US
Practice Address - Phone:808-938-6525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-06
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41420225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP932Medicare PIN
CACA134830Medicare PIN