Healthcare Provider Details

I. General information

NPI: 1528559515
Provider Name (Legal Business Name): PRIYANKA BASSI RDH, RN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2018
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

857 W CHILDS AVE
MERCED CA
95341-6862
US

IV. Provider business mailing address

2422 SIERRA SPRINGS CT
ATWATER CA
95301-9216
US

V. Phone/Fax

Practice location:
  • Phone: 209-722-4842
  • Fax:
Mailing address:
  • Phone: 209-535-4102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number25651
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number95352446
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95038898
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: