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Individual
JUDITH MARIE BASTIN
Active
Individual
JUDITH MARIE BASTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070753
MASTER PROVIDER NUMBER
CA
01
—
0753
MEDI-CAL BILLING NUMBER
CA
Enumeration date
05/11/2007
Last updated
07/08/2007
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