Provider Demographics
NPI:1619619384
Name:PAUL, ASHLEY K (MFT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:K
Last Name:PAUL
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2067 KELLOGG WAY
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-2453
Mailing Address - Country:US
Mailing Address - Phone:916-812-3863
Mailing Address - Fax:
Practice Address - Street 1:2067 KELLOGG WAY
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-2453
Practice Address - Country:US
Practice Address - Phone:916-812-3863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA115830106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist