Individual
DR. ANNA BASANTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
12625 HIGH BLUFF DR STE 204, SAN DIEGO, CA 92130-2053
(858) 692-4187
Mailing address
2562 NORTHSIDE DR, APT 401, SAN DIEGO, CA 92108-6783
(425) 308-8073
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY35341
CA
Other
Enumeration date
11/05/2024
Last updated
11/05/2024
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