Provider Demographics
NPI:1558977850
Name:BOYD, ASHTON GRACE
Entity Type:Individual
Prefix:
First Name:ASHTON
Middle Name:GRACE
Last Name:BOYD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1039 THOMPSON CIR
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-7532
Mailing Address - Country:US
Mailing Address - Phone:916-934-8828
Mailing Address - Fax:
Practice Address - Street 1:9470 MICRON AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-2612
Practice Address - Country:US
Practice Address - Phone:916-337-9842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician