Ashley Grant
Individual provider Active NPI Marriage & Family Therapist · Cotati, CA
NPI 1740782812 · NPPES record last updated Sep 15, 2021
Key facts
- NPI
- 1740782812
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 105584 (CA)
- Practice address
- 112 Jagla St
Cotati, CA 94931-5407 - Phone
- (415) 993-0553
- NPI assigned
- Mar 5, 2018
- Reactivated
- Aug 20, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105584 | CA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 105584 | CA | Yes |
Addresses
Primary practice location
112 Jagla St
Cotati, CA 94931-5407
Mailing address
PO Box 261
Cotati, CA 94931-0261
Phone (415) 993-0553
Other practice location 1
295 Fell St
San Francisco, CA 94102-5147
Phone (415) 310-0246
Other providers in Cotati, CA
- Miranda Quinn Florez
- Victoria Fontanot
- Rebecca Ranz Gilbert
- Sheila Louise Good
- Brandon Goodman
- Ida Marie Hallgren-Luke
- Wesley Joseph Hamper
- Faith Harville-Polk
- Wendy Lee Haynes
- Katheen R. Haynie
All providers in Cotati, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.