Provider Demographics
NPI:1801185277
Name:ASCENCIO, ASHLEY (DO)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:
Last Name:ASCENCIO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6606 RAINBOW AVE
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:KS
Mailing Address - Zip Code:66208-1968
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6606 RAINBOW AVE
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:KS
Practice Address - Zip Code:66208-1968
Practice Address - Country:US
Practice Address - Phone:949-294-8420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012029298208D00000X
KS05-35969208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice