Provider Demographics
NPI:1790088094
Name:TRINO, ASHLEY BENZ (PT)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:BENZ
Last Name:TRINO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9161 SIERRA AVE
Mailing Address - Street 2:SUITE 211
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-4729
Mailing Address - Country:US
Mailing Address - Phone:909-428-6882
Mailing Address - Fax:
Practice Address - Street 1:9161 SIERRA AVE
Practice Address - Street 2:SUITE 211
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-4729
Practice Address - Country:US
Practice Address - Phone:909-428-6882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-09
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT36417225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist