Individual
SUSAN JOY BASTING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4776 SONG BIRD, CHICO, CA 95973-9766
(530) 891-5442
(530) 892-2979
Mailing address
701 E LASSEN AVE, #36, CHICO, CA 95973-0751
(530) 891-0822
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
VN61415
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EPSO16770
MEDICAL
CA
01
—
RVNO04910
MEDICAL
CA
Enumeration date
05/30/2007
Last updated
07/08/2007
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