Individual
ASHLEY RENDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1609 BAKER ST, COSTA MESA, CA 92626-3701
(949) 791-9401
Mailing address
1609 BAKER ST, COSTA MESA, CA 92626-3701
(949) 791-9401
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
300163
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300163
LICENSE NUMBER
CA
Enumeration date
05/15/2021
Last updated
10/03/2024
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