Provider Demographics
NPI:1750550588
Name:CODA, BESMA
Entity type:Individual
Prefix:
First Name:BESMA
Middle Name:
Last Name:CODA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5060 BLUFF PL
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-8212
Mailing Address - Country:US
Mailing Address - Phone:619-300-2331
Mailing Address - Fax:
Practice Address - Street 1:343 E MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-3913
Practice Address - Country:US
Practice Address - Phone:619-631-7400
Practice Address - Fax:619-631-7400
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor