Provider Demographics
NPI:1881583748
Name:ERTAS, AYSE
Entity type:Individual
Prefix:
First Name:AYSE
Middle Name:
Last Name:ERTAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:ERTAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1031 25TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92102-2102
Mailing Address - Country:US
Mailing Address - Phone:619-708-4380
Mailing Address - Fax:
Practice Address - Street 1:1031 25TH ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92102-2102
Practice Address - Country:US
Practice Address - Phone:619-708-4380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1288431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical