Provider Demographics
NPI:1487303798
Name:WOLFFE, ASHTON (MSOT)
Entity type:Individual
Prefix:
First Name:ASHTON
Middle Name:
Last Name:WOLFFE
Suffix:
Gender:F
Credentials:MSOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5513 FLORIDA DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-4632
Mailing Address - Country:US
Mailing Address - Phone:323-333-6731
Mailing Address - Fax:
Practice Address - Street 1:1050 SAN MIGUEL RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-2094
Practice Address - Country:US
Practice Address - Phone:323-333-6731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21336225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist