Provider Demographics
NPI:1497152482
Name:DAVILLA, ASHLEY (LVN)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:
Last Name:DAVILLA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:VIOLET
Other - Last Name:HOUCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4812 BAYSIDE WAY
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94561-3248
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4812 BAYSIDE WAY
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:CA
Practice Address - Zip Code:94561-3248
Practice Address - Country:US
Practice Address - Phone:925-234-2995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA283398164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse