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General NPI Number Information
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NPI Number | 1003787615
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Entity Type | Individual
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Provider Name | MARCY B BASILA
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Gender | Female
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Dates
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Enumeration Date | 09/16/2025
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 5200 MARYSVILLE BLVD
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City | SACRAMENTO
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State | CA
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Zip | 95838-1600
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Country | US
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Telephone | 916-268-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 2208 FRUITRIDGE RD
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City | SACRAMENTO
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State | CA
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Zip | 95822-3130
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Country | US
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Telephone | 916-268-2500
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 118617
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License Number State | CA
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