Provider Demographics
NPI:1144552738
Name:PEARSALL, ASHLEY THOMPSON (DPT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:THOMPSON
Last Name:PEARSALL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:LYNN
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20823 STEVENS CREEK BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014
Mailing Address - Country:US
Mailing Address - Phone:408-252-6076
Mailing Address - Fax:916-933-0871
Practice Address - Street 1:907 EMBARCADERO DR
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-4087
Practice Address - Country:US
Practice Address - Phone:916-933-1221
Practice Address - Fax:916-933-0871
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT36337225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT36337OtherLICENSE NUMBER