Kathleen Basco
Licensed Psychiatric Technician in Fairfield, CA. Individual provider (NPI-1).
NPI number1508681990
StatusActive
Last updated in NPPESNov 20, 2024
Details
- NPI
- 1508681990
- Entity type
- Individual (NPI-1)
- Name
- Kathleen Basco
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 20, 2024
- Certification date
- Nov 20, 2024
- Last updated
- Nov 20, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 167G00000X | Licensed Psychiatric Technician | 37313 | CA | Yes |
Practice location
1480 Descanso LnFairfield, CA 94533-7149
Phone 909-838-1514
Mailing address
1480 Descanso LnFairfield, CA 94533-7149
Phone 909-838-1514
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