Provider Demographics
NPI:1306314299
Name:TUVELL, ASHLEY ALICIA
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ALICIA
Last Name:TUVELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 FOREST GLEN DR APT 143
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-3077
Mailing Address - Country:US
Mailing Address - Phone:626-991-8477
Mailing Address - Fax:
Practice Address - Street 1:17727 E CYPRESS ST
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722-2634
Practice Address - Country:US
Practice Address - Phone:626-858-4920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-08
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)