Provider Demographics
NPI:1902098676
Name:ASHBY, ANITA CATHERINE (NP)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:CATHERINE
Last Name:ASHBY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9533 YEW ST
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-2250
Mailing Address - Country:US
Mailing Address - Phone:909-987-3463
Mailing Address - Fax:
Practice Address - Street 1:9533 YEW ST
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-2250
Practice Address - Country:US
Practice Address - Phone:909-987-3463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA228172363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health