Provider Demographics
NPI:1356730196
Name:COMBEST, MEGAN MARIE (BCABA)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:MARIE
Last Name:COMBEST
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:MARIE
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCABA
Mailing Address - Street 1:42037 VIA RENATE
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-5325
Mailing Address - Country:US
Mailing Address - Phone:210-383-2983
Mailing Address - Fax:
Practice Address - Street 1:1200 CONCORD AVE STE 100
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-4969
Practice Address - Country:US
Practice Address - Phone:510-407-4892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-16
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0-19-10039106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst