Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 49802 | CA |
NPI | 1013500875 |
---|---|
Provider Name | Ashley Cribbs |
First Address | Ventura, CA 93003-7139 |
Second Address | Ventura, CA 93003-2803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2021 |
Last Update Date | 12/02/2021 |