Healthcare Provider Details

I. General information

NPI: 1154239432
Provider Name (Legal Business Name): BASAK KAYA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1761 HOTEL CIR S STE 118
SAN DIEGO CA
92108-3318
US

IV. Provider business mailing address

3911 CLEVELAND AVE UNIT 3414
SAN DIEGO CA
92163-7018
US

V. Phone/Fax

Practice location:
  • Phone: 858-232-1836
  • Fax:
Mailing address:
  • Phone: 619-736-7208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number23698
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: