Provider Demographics
NPI:1376840330
Name:ASHE, PAMELA ELAINE (PHD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:ELAINE
Last Name:ASHE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 GRAYBURN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-1940
Mailing Address - Country:US
Mailing Address - Phone:310-365-2934
Mailing Address - Fax:
Practice Address - Street 1:5855 GREEN VALLEY CIR
Practice Address - Street 2:SUITE 202
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6946
Practice Address - Country:US
Practice Address - Phone:310-365-2934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-26
Last Update Date:2011-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15985103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist