Individual
JESSE BASSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4131 51ST ST APT 6J, WOODSIDE, NY 11377-4448
(914) 482-5026
Mailing address
2417 MICHIGAN AVE, SANTA MONICA, CA 90404-4009
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
08/23/2023
Last updated
08/23/2023
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