Provider Demographics
NPI:1851998389
Name:ROBERTS, ASHLEN TAYLOR (DPT)
Entity Type:Individual
Prefix:
First Name:ASHLEN
Middle Name:TAYLOR
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ASHLEN
Other - Middle Name:TAYLOR
Other - Last Name:PAUSTENBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2217 SUNSET BLVD STE 711
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-4783
Mailing Address - Country:US
Mailing Address - Phone:916-435-3500
Mailing Address - Fax:
Practice Address - Street 1:2217 SUNSET BLVD STE 711
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-4783
Practice Address - Country:US
Practice Address - Phone:916-435-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA299259225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist