Provider Demographics
NPI:1619187796
Name:ASHWORTH, GALE (RD, MS)
Entity Type:Individual
Prefix:
First Name:GALE
Middle Name:
Last Name:ASHWORTH
Suffix:
Gender:F
Credentials:RD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 MORSE AVE
Mailing Address - Street 2:DEPT OF PEDIATRIC SUBSPECIALTIES, STATION 1 B
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-2115
Mailing Address - Country:US
Mailing Address - Phone:916-973-5568
Mailing Address - Fax:916-973-7338
Practice Address - Street 1:2025 MORSE AVE
Practice Address - Street 2:DEPT OF PEDIATRIC SUBSPECIALTIES, STATION 1 B
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-2115
Practice Address - Country:US
Practice Address - Phone:916-973-5568
Practice Address - Fax:916-973-7338
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5893039133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered