Individual provider Active NPI

Ashley Elizabeth Hupp, PA-C

  • Physician Assistant
  • Healdsburg, CA
National Provider Identifier
1629968821
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1312 Prentice Dr
Healdsburg, CA 95448-3381
Phone
(707) 433-3383
NPI assigned
Jul 8, 2025
Last updated
Dec 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1312 Prentice Dr
Healdsburg, CA 95448-3381

Mailing address

1312 Prentice Dr
Healdsburg, CA 95448-3381
Phone (707) 433-3383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260106001675 CA Practitioner - Physician Assistant 7911493382 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1375 University St
Healdsburg, CA 95448-3382

909 Robert Ave
Woodbury, TN 37190-1649

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
66879CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Norcal Healthconnect LLC CurrentSince Nov 3, 2025 Accepting new patients
Norcal Healthconnect LLC CurrentSince Nov 3, 2025 Accepting new patients
North Sonoma County Health Care District Past Accepting new patients

Locations

1312 Prentice Dr
Healdsburg, CA 95448
Phone (707) 433-3383

1375 University St
Healdsburg, CA 95448
Phone (707) 385-2025

110 Lynch Creek Way
#B
Petaluma, CA 94954
Phone (707) 522-4348

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1751932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1629968821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 PRENTICE DR",
            "city": "HEALDSBURG",
            "state": "CA",
            "postal_code": "954483381",
            "telephone_number": "707-433-3383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 PRENTICE DR",
            "city": "HEALDSBURG",
            "state": "CA",
            "postal_code": "954483381",
            "telephone_number": "707-433-3383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUPP",
        "first_name": "ASHLEY",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Healdsburg, CA

Sources for this page

Verify at the official NPI Registry.