Individual
KIRSTEN BAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2516 VERNE ROBERTS CIR STE H102, ANTIOCH, CA 94509-7918
(925) 635-4864
Mailing address
4233 REIDS WAY, TRACY, CA 95377-8348
(209) 597-2163
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
24457
CA
Other
Enumeration date
05/09/2023
Last updated
05/09/2023
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