Provider Demographics
NPI:1821164450
Name:ASHABI, ELLA (PHD MS BS DOM)
Entity Type:Individual
Prefix:MRS
First Name:ELLA
Middle Name:
Last Name:ASHABI
Suffix:
Gender:F
Credentials:PHD MS BS DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12921 FAIRHAVEN EXT
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-1357
Mailing Address - Country:US
Mailing Address - Phone:949-955-9499
Mailing Address - Fax:949-916-6659
Practice Address - Street 1:23722 BIRTCHER DR
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-1771
Practice Address - Country:US
Practice Address - Phone:949-344-9707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALAC5665171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5665Medicaid