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NPI Code Detail

MEDICARE: HALA KHAMIS

MEDICARE: HALA KHAMIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist122794CA

General Provider Information

NPI Number : 1588334593
Entity Type Code : Individual
Provider Name (Legal Business Name) : HALA KHAMIS
Provider Business Mailing Address
First Line : 3616 LUNA AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92117-2626
Country : US
Telephone Number : 831-920-8310
Fax Number :
Provider Business Practice Location Address
First Line : 1010 TURQUOISE ST STE 303
Second Line :
City : SAN DIEGO
State : CA
Zip : 92109-1268
Country : US
Telephone Number : 858-255-4095
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2021
Last Update Date : 09/20/2021

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Directions to “ HALA KHAMIS ” Practice Location

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