Provider Demographics
NPI:1831593326
Name:ALI, AYESHA AMJAD (FNP-C, WHCNP)
Entity type:Individual
Prefix:MS
First Name:AYESHA
Middle Name:AMJAD
Last Name:ALI
Suffix:
Gender:F
Credentials:FNP-C, WHCNP
Other - Prefix:MS
Other - First Name:AYESHA
Other - Middle Name:TASAWAR
Other - Last Name:HUSSAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1559
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-1559
Mailing Address - Country:US
Mailing Address - Phone:661-635-3050
Mailing Address - Fax:661-326-1347
Practice Address - Street 1:3645 W SHAW AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3206
Practice Address - Country:US
Practice Address - Phone:559-457-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-14
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236107363LW0102X
CA95001202363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health