Provider Demographics
NPI:1396256251
Name:ASHISH, DEV (PHD)
Entity type:Individual
Prefix:DR
First Name:DEV
Middle Name:
Last Name:ASHISH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3045 N 1ST AVE STE A
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-2560
Mailing Address - Country:US
Mailing Address - Phone:520-539-6455
Mailing Address - Fax:
Practice Address - Street 1:3045 N 1ST AVE STE A
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-2560
Practice Address - Country:US
Practice Address - Phone:719-200-8224
Practice Address - Fax:844-227-8699
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-18
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4907103TA0700X, 103TB0200X, 103TP2701X, 103TC0700X, 103TP2701X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation