Provider Demographics
NPI:1407929433
Name:ASHBY, MARTA HAMMOND (CRNA)
Entity Type:Individual
Prefix:
First Name:MARTA
Middle Name:HAMMOND
Last Name:ASHBY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 SERENO DR
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94589-2441
Mailing Address - Country:US
Mailing Address - Phone:925-890-0770
Mailing Address - Fax:925-229-9463
Practice Address - Street 1:975 SERENO DR
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2441
Practice Address - Country:US
Practice Address - Phone:707-651-3884
Practice Address - Fax:707-651-2045
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN3158950OtherMEDI-CAL PROVIDER ID
CARN3158950OtherMEDI-CAL PROVIDER ID