Individual
ASHLEY CLARA GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1021 MEMORY LN, ESCONDIDO, CA 92026-1722
(480) 739-7068
Mailing address
804 E WASHINGTON AVE UNIT C, ESCONDIDO, CA 92025-2189
(442) 317-9969
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F5150114
DRIVER LICENSE
CA
Enumeration date
06/20/2023
Last updated
06/20/2023
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