Provider Demographics
NPI:1902151269
Name:HARRAH, ASHLEE KRISTINE (PA)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:KRISTINE
Last Name:HARRAH
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ASHLEE
Other - Middle Name:KRISTINE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1 QUALITY DR
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-9494
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:2725 CAPITOL AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-6004
Practice Address - Country:US
Practice Address - Phone:916-262-9440
Practice Address - Fax:916-262-9445
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA22384363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant