Provider Demographics
NPI:1790516144
Name:BILLS, ASHLEY (MATRN, ATC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BILLS
Suffix:
Gender:F
Credentials:MATRN, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1773 E FREDERICK AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2794
Mailing Address - Country:US
Mailing Address - Phone:408-420-9360
Mailing Address - Fax:
Practice Address - Street 1:1630 E BULLDOG LN
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710
Practice Address - Country:US
Practice Address - Phone:408-420-0936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20000563892255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer