Provider Demographics
NPI:1205693389
Name:BECKER, ASHLEY ROSE (OTR/L)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ROSE
Last Name:BECKER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5390 ASPENWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-5414
Mailing Address - Country:US
Mailing Address - Phone:925-948-5956
Mailing Address - Fax:
Practice Address - Street 1:201 SAND CREEK RD STE G4
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-2494
Practice Address - Country:US
Practice Address - Phone:925-529-4790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25578225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist