Provider Demographics
NPI:1841769825
Name:SHASHA, REESE HALABIA
Entity Type:Individual
Prefix:MRS
First Name:REESE
Middle Name:HALABIA
Last Name:SHASHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RAYYA
Other - Middle Name:MUMTAZ
Other - Last Name:HALABIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:916 TEATRO CIR
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-5183
Mailing Address - Country:US
Mailing Address - Phone:619-715-5642
Mailing Address - Fax:
Practice Address - Street 1:333 E MAIN ST
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-3913
Practice Address - Country:US
Practice Address - Phone:619-938-3239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator