Provider Demographics
NPI:1568253060
Name:PERKINS-GENTRY, ASHLEY B
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:B
Last Name:PERKINS-GENTRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:PERKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:400 CONCAR DR STE 4-134
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-2681
Mailing Address - Country:US
Mailing Address - Phone:650-931-6300
Mailing Address - Fax:
Practice Address - Street 1:400 CONCAR DR STE 4-134
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-2681
Practice Address - Country:US
Practice Address - Phone:650-931-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician