Individual
BASTY A MENJIVAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
1100 SPORTFISHER DR, OCEANSIDE, CA 92054-2550
(760) 439-6702
Mailing address
257 E EL SUR ST, MONROVIA, CA 91016-4801
(626) 861-6311
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
CA
Other
Enumeration date
05/27/2021
Last updated
05/27/2021
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