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General NPI Number Information
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NPI Number | 1063353282
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Entity Type | Individual
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Provider Name | SYDNEY BASTI
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Gender | Female
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Dates
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Enumeration Date | 04/02/2026
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 1234 S POWER RD STE 252
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City | MESA
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State | AZ
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Zip | 85206-3700
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Country | US
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Telephone | 602-675-6185
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Fax |
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Provider Business Mailing Address
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Address Line | 2255 S BAHAMA DR
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City | GILBERT
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State | AZ
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Zip | 85295-5634
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LMSW-22674
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License Number State | AZ
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