Provider Demographics
NPI:1619595931
Name:GARCIA, ASHLEY RAE (BA)
Entity Type:Individual
Prefix:
First Name:ASHLEY RAE
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 N GRAND AVE STE D
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724-1552
Mailing Address - Country:US
Mailing Address - Phone:626-967-1167
Mailing Address - Fax:
Practice Address - Street 1:1126 N GRAND AVE STE D
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724-1552
Practice Address - Country:US
Practice Address - Phone:626-967-1167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program