Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 3523 | CO |
Y | 103TC0700X | Clinical Psychologist | 3523 | CO |
N | 103G00000X | Clinical Psychologist | 4006 | AZ |
N | 103TC0700X | Clinical Psychologist | 4006 | AZ |
N | 103G00000X | Clinical Psychologist | 4793704-2501 | UT |
N | 103TC0700X | Clinical Psychologist | 4793704-2501 | UT |
N | 1041C0700X | Clinical Social Worker | 4793704-3501 | UT |
NPI | 1013108695 |
---|---|
Provider Name | Dr. Ashley Bittle |
First Address | Camp Pendleton, CA 92055-5191 |
Second Address | Camp Pendleton, CA 92055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2007 |
Last Update Date | 20/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013108695 | NPI (01) |