Provider Demographics
NPI:1881207769
Name:SMITH, ASHLEY LEANN (LVN, PD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LEANN
Last Name:SMITH
Suffix:
Gender:F
Credentials:LVN, PD
Other - Prefix:MRS
Other - First Name:ASHLEY
Other - Middle Name:LEANN
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LVN, PD
Mailing Address - Street 1:2010 W AVENUE K # 661
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-5229
Mailing Address - Country:US
Mailing Address - Phone:661-268-9768
Mailing Address - Fax:
Practice Address - Street 1:6109 W AVENUE J11
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-1747
Practice Address - Country:US
Practice Address - Phone:661-268-9768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN703854164X00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No164X00000XNursing Service ProvidersLicensed Vocational Nurse