Healthcare Provider Details

I. General information

NPI: 1003307679
Provider Name (Legal Business Name): JASPREET SINGH BASI OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2018
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 E MERCED ST
FOWLER CA
93625-2316
US

IV. Provider business mailing address

11303 N VIA NAPOLI DR
FRESNO CA
93730-8832
US

V. Phone/Fax

Practice location:
  • Phone: 559-917-2421
  • Fax:
Mailing address:
  • Phone: 559-917-2421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number21561
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT15410
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: