Provider Demographics
NPI:1366570889
Name:ASHCRAFT, BETH ANN (MPT)
Entity type:Individual
Prefix:MS
First Name:BETH
Middle Name:ANN
Last Name:ASHCRAFT
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11590 W BERNARDO CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-1622
Mailing Address - Country:US
Mailing Address - Phone:858-432-4749
Mailing Address - Fax:858-432-4750
Practice Address - Street 1:11590 W BERNARDO CT
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1622
Practice Address - Country:US
Practice Address - Phone:858-432-4749
Practice Address - Fax:858-432-4750
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261012251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics