Individual
STEFANIE BASSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPT CNS, MS
Contact information
Practice address
6612 MISSION GORGE RD STE B, SAN DIEGO, CA 92120-2346
(808) 226-2113
Mailing address
4225 PORTE DE MERANO UNIT 92, SAN DIEGO, CA 92122-1935
(808) 226-2113
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
2717254
CA
Other
Enumeration date
10/19/2022
Last updated
10/19/2022
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