Provider Demographics
NPI:1861026379
Name:EHSAN, BAHIA (MS)
Entity Type:Individual
Prefix:
First Name:BAHIA
Middle Name:
Last Name:EHSAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:FATIMA
Other - Middle Name:
Other - Last Name:SYED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:3906 LOMA VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619-1426
Mailing Address - Country:US
Mailing Address - Phone:510-860-0543
Mailing Address - Fax:
Practice Address - Street 1:3906 LOMA VISTA AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94619-1426
Practice Address - Country:US
Practice Address - Phone:510-860-0543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health