Individual
AYESHA NICOLE BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 340501, SACRAMENTO, CA 95834-0501
(916) 400-1588
Mailing address
520 SAMUEL WAY, SACRAMENTO, CA 95838-2690
(916) 400-1588
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
127563
CA
Other
Enumeration date
09/27/2021
Last updated
01/06/2025
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