Individual
HEIDI LA BASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
VA SAN DIEGO HEALTHCARE SYSTEM, 3350 LA JOLLA VILLAGE DRIVE (RESEARCH SERVICE), SAN DIEGO, CA 92161
(617) 877-2960
Mailing address
VA SAN DIEGO HEALTHCARE SYSTEM, 3350 LA JOLLA VILLAGE DRIVE (RESEARCH SERVICE), SAN DIEGO, CA 92161
(617) 877-2960
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY32021
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY32021
CALIFORNIA BOARD OF PSYCHOLOGY
CA
Enumeration date
06/06/2024
Last updated
06/06/2024
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