Individual
AYSHA BHUMBLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3333 CHANATE RD, SANTA ROSA, CA 95404
(707) 565-5723
Mailing address
3333 CHANATE RD, SANTA ROSA, CA 95404-1707
(707) 565-5723
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/27/2016
Last updated
05/22/2018
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