Healthcare Provider Details

I. General information

NPI: 1558245365
Provider Name (Legal Business Name): BELINDA ELAINE BASSETT LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 12/28/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 W F ST STE 101
ONTARIO CA
91762-3201
US

IV. Provider business mailing address

125 W F ST STE 101
ONTARIO CA
91762-3201
US

V. Phone/Fax

Practice location:
  • Phone: 818-476-8514
  • Fax: 818-476-8514
Mailing address:
  • Phone: 909-563-7076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number286401
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: