Provider Demographics
NPI:1740513068
Name:BART, ASHLEY LYNN
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LYNN
Last Name:BART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 W. HILLDSALE BLVD. APT B
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94003
Mailing Address - Country:US
Mailing Address - Phone:626-319-9009
Mailing Address - Fax:
Practice Address - Street 1:138 W HILLSDALE BLVD APT B
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-4216
Practice Address - Country:US
Practice Address - Phone:626-319-9009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-18
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health