Provider Demographics
NPI:1689093072
Name:BESSETTE, SHAUNA LEE ANN (MS)
Entity Type:Individual
Prefix:MRS
First Name:SHAUNA
Middle Name:LEE ANN
Last Name:BESSETTE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:SHAUNA
Other - Middle Name:LEE-ANN
Other - Last Name:CURTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:3903 CONRAD DR APT 64
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-1447
Mailing Address - Country:US
Mailing Address - Phone:760-680-6227
Mailing Address - Fax:
Practice Address - Street 1:3443 CAMINO DEL RIO S STE 202
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3914
Practice Address - Country:US
Practice Address - Phone:619-270-5622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 73691106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist