Provider Demographics
NPI:1053921569
Name:ELLMAN-KASSING, ASHA RACHEL
Entity type:Individual
Prefix:
First Name:ASHA
Middle Name:RACHEL
Last Name:ELLMAN-KASSING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHA
Other - Middle Name:RACHEL
Other - Last Name:KASSING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3053 FREEPORT BLVD # 427
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-4346
Mailing Address - Country:US
Mailing Address - Phone:916-595-0007
Mailing Address - Fax:
Practice Address - Street 1:3053 FREEPORT BLVD # 427
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95818-4346
Practice Address - Country:US
Practice Address - Phone:916-595-0007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program