Healthcare Provider Details

I. General information

NPI: 1427894013
Provider Name (Legal Business Name): SUKHMANI K BASSI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2024
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

539 N VAN NESS AVE
FRESNO CA
93728-3419
US

IV. Provider business mailing address

200 7TH AVE STE 150
SANTA CRUZ CA
95062-4669
US

V. Phone/Fax

Practice location:
  • Phone: 559-266-9581
  • Fax: 559-498-0507
Mailing address:
  • Phone: 831-462-1060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number717213
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: