Provider Demographics
NPI:1598305286
Name:ASHBY, TAYLOR C
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:C
Last Name:ASHBY
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 1:1300 E SHAW AVE STE 172
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7911
Mailing Address - Country:US
Mailing Address - Phone:559-554-9710
Mailing Address - Fax:
Practice Address - Street 1:1300 E SHAW AVE STE 172
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7911
Practice Address - Country:US
Practice Address - Phone:559-554-9711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health