Provider Demographics
NPI:1144869488
Name:LATTIER, ASHLEY MARI
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARI
Last Name:LATTIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2338 BOBWHITE CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-2433
Mailing Address - Country:US
Mailing Address - Phone:707-720-9045
Mailing Address - Fax:
Practice Address - Street 1:2338 BOBWHITE CT
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-2433
Practice Address - Country:US
Practice Address - Phone:707-720-9045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA687282164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse