Provider Demographics
NPI:1730379785
Name:NASH, AIMEE ALLISON (RDA, OM)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:ALLISON
Last Name:NASH
Suffix:
Gender:F
Credentials:RDA, OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 LA GONDA WAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-1727
Mailing Address - Country:US
Mailing Address - Phone:925-837-8048
Mailing Address - Fax:925-837-8049
Practice Address - Street 1:530 LA GONDA WAY
Practice Address - Street 2:SUITE B
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-1727
Practice Address - Country:US
Practice Address - Phone:925-837-8048
Practice Address - Fax:925-837-8049
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA684682251H1300X, 126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant
No2251H1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHuman Factors