Provider Demographics
NPI:1912375155
Name:MCGROGAN, ASHLEY LOUISE (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LOUISE
Last Name:MCGROGAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2027 VILLAGE LN
Mailing Address - Street 2:STE 102
Mailing Address - City:SOLVANG
Mailing Address - State:CA
Mailing Address - Zip Code:93463-2283
Mailing Address - Country:US
Mailing Address - Phone:805-324-3519
Mailing Address - Fax:
Practice Address - Street 1:2027 VILLAGE LN
Practice Address - Street 2:SUITE 102
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-2283
Practice Address - Country:US
Practice Address - Phone:805-688-3440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-04
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52817363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant