Provider Demographics
NPI:1396146882
Name:MCCABE, ASHLEY DIANE (NP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:DIANE
Last Name:MCCABE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:DIANE
Other - Last Name:STARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:7755 CENTER AVE
Mailing Address - Street 2:SUITE # 630
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-3007
Mailing Address - Country:US
Mailing Address - Phone:657-237-2450
Mailing Address - Fax:714-455-3686
Practice Address - Street 1:3401 CENTRE LAKE DR STE 512
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-1201
Practice Address - Country:US
Practice Address - Phone:909-566-0445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001331363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care