Provider Demographics
NPI:1215502737
Name:GENERA, ASHLEY VIOLET (PA-S2)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:VIOLET
Last Name:GENERA
Suffix:
Gender:F
Credentials:PA-S2
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Other - Credentials:
Mailing Address - Street 1:1000 S FREMONT AVE
Mailing Address - Street 2:UNIT 7, BLD A10, N10100
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-8897
Mailing Address - Country:US
Mailing Address - Phone:626-457-4240
Mailing Address - Fax:626-457-4245
Practice Address - Street 1:1000 S FREMONT AVE
Practice Address - Street 2:UNIT 7, BLD A10, N10100
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-8897
Practice Address - Country:US
Practice Address - Phone:626-457-4240
Practice Address - Fax:626-457-4245
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2024-05-06
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician