Provider Demographics
NPI:1952110488
Name:HENRY, ASHLEY KRISTINA
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:KRISTINA
Last Name:HENRY
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 1:2354 IDAHO WAY
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-8468
Mailing Address - Country:US
Mailing Address - Phone:530-923-0056
Mailing Address - Fax:
Practice Address - Street 1:1103 BUTTE HOUSE RD
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3109
Practice Address - Country:US
Practice Address - Phone:530-913-7221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW1189701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical