Provider Demographics
NPI:1093930265
Name:BEN-HORIN, HALLIE I (PHD)
Entity Type:Individual
Prefix:DR
First Name:HALLIE
Middle Name:
Last Name:BEN-HORIN
Suffix:I
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 STEVENS AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-2065
Mailing Address - Country:US
Mailing Address - Phone:760-864-2266
Mailing Address - Fax:
Practice Address - Street 1:462 STEVENS AVE STE 108
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2065
Practice Address - Country:US
Practice Address - Phone:760-864-2266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18480103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist