Provider Demographics
NPI:1376729574
Name:LASHLEY, MARK WILLIAM (ADDICTION SPECIALIST)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:WILLIAM
Last Name:LASHLEY
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Gender:M
Credentials:ADDICTION SPECIALIST
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Other - First Name:
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Mailing Address - Street 1:11960 HERITAGE OAK PL
Mailing Address - Street 2:SUITE #15
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-2401
Mailing Address - Country:US
Mailing Address - Phone:530-885-1961
Mailing Address - Fax:530-885-0713
Practice Address - Street 1:11960 HERITAGE OAK PL
Practice Address - Street 2:SUITE #15
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-2401
Practice Address - Country:US
Practice Address - Phone:530-885-1961
Practice Address - Fax:530-885-0713
Is Sole Proprietor?:No
Enumeration Date:2008-01-17
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA31-001-02-120101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)