Individual
ANTONETTE BASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
251 LLEWELLYN AVE, CAMPBELL, CA 95008-1940
(408) 379-3790
Mailing address
251 LLEWELLYN AVE, CAMPBELL, CA 95008-1940
(408) 379-3790
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN 211071
CA
Other
Enumeration date
11/17/2016
Last updated
12/05/2016
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