Provider Demographics
NPI:1942815998
Name:BUTLER, ASHLI (FNP)
Entity Type:Individual
Prefix:
First Name:ASHLI
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2433 CENTRAL AVE STE A
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4564
Mailing Address - Country:US
Mailing Address - Phone:510-521-2300
Mailing Address - Fax:
Practice Address - Street 1:2433 CENTRAL AVE STE A
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4564
Practice Address - Country:US
Practice Address - Phone:510-521-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95015466363LF0000X, 363L00000X
CA95173512163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse