Individual
MS. TRACI R BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
345 E TRAVIS BLVD, FAIRFIELD, CA 94533-3958
(510) 899-3704
Mailing address
345 E TRAVIS BLVD, FAIRFIELD, CA 94533-3958
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/24/2008
Last updated
02/05/2025
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