Provider Demographics
NPI:1013684422
Name:CHANG, ASHLEY VINH (PT, DPT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:VINH
Last Name:CHANG
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:VINH
Other - Last Name:TANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:19107 BECHARD AVE
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-7204
Mailing Address - Country:US
Mailing Address - Phone:562-608-5022
Mailing Address - Fax:
Practice Address - Street 1:9353 IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-2812
Practice Address - Country:US
Practice Address - Phone:833-574-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300762225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist