Provider Demographics
NPI:1053779868
Name:HARRINAUTH, ASHLEY NICOLE (MA, MBA)
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:NICOLE
Last Name:HARRINAUTH
Suffix:
Gender:F
Credentials:MA, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2049
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-0204
Mailing Address - Country:US
Mailing Address - Phone:916-287-1750
Mailing Address - Fax:
Practice Address - Street 1:1745 ENTERPRISE DR BLDG 2
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-5801
Practice Address - Country:US
Practice Address - Phone:916-287-1750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-08
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB94024300103T00000X
CAIMF88123106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty