Individual
ASHLEY TRAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 PETALUMA BLVD S, PETALUMA, CA 94952-5545
(707) 765-8488
Mailing address
24 TRUMAN DR, NOVATO, CA 94947-4460
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
CA
Other
Enumeration date
09/13/2022
Last updated
09/13/2022
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