Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ashley Lynn Detore, PA

Individual provider Physician Assistant · NPI 1174143101

Ashley Lynn Detore, PA is a Physician Assistant in Greenbrae, California. Qualified in 2020, 6 years ago. Practices with Regents Univ of California UCSF, a 272-clinician group and offers telehealth. Licensed in California.

Years since qualifying
6
Licensed in
CA
In the registry since
2020
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1350 S Eliseo Dr Ste 300
Greenbrae, CA 94904-2011
Phone: (484) 332-8149
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 61109 (CA)

Record details

NPI number1174143101
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedApril 20, 2020
Last updated in NPPESDecember 9, 2024
Certification dateDecember 9, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Regents Univ Of California Ucsf — 272 clinicians
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services

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