Healthcare Provider Details

I. General information

NPI: 1285896431
Provider Name (Legal Business Name): JANE M BASSATT-WINCHELL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2542 S BASCOM AVE STE 110
CAMPBELL CA
95008-5541
US

IV. Provider business mailing address

5492 TYHURST WALKWAY APT 2
SAN JOSE CA
95123-1861
US

V. Phone/Fax

Practice location:
  • Phone: 408-559-3403
  • Fax: 408-559-3158
Mailing address:
  • Phone: 585-255-0512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW70627
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: