Provider Demographics
NPI:1518090455
Name:BESAW, PAMELA FAYE (RN, PHN)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:FAYE
Last Name:BESAW
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25205 PODERIO DR
Mailing Address - Street 2:
Mailing Address - City:RAMONA
Mailing Address - State:CA
Mailing Address - Zip Code:92065-4713
Mailing Address - Country:US
Mailing Address - Phone:760-789-8104
Mailing Address - Fax:619-401-3600
Practice Address - Street 1:104 BARNES ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-3406
Practice Address - Country:US
Practice Address - Phone:760-967-4531
Practice Address - Fax:760-967-4644
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA508336163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health