Individual
MISS ASHLYN MARIE FAUSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AOD COUNSELOR
Contact information
Practice address
2403 PROFESSIONAL DR, SANTA ROSA, CA 95403-3007
(707) 544-3295
Mailing address
2403 PROFESSIONAL DR, SANTA ROSA, CA 95403-3007
(707) 544-3295
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
490009BN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490009BN
—
CA
Enumeration date
09/08/2022
Last updated
09/08/2022
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