Individual
ASHLEY SOUTHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1207 E FRUIT ST, SANTA ANA, CA 92701-4296
(714) 486-0940
Mailing address
786 LA DOCENA LN, CORONA, CA 92879-8534
(951) 367-4367
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1498310223
CA
Other
Enumeration date
12/28/2022
Last updated
03/06/2023
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