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General NPI Number Information
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NPI Number | 1427727908
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Entity Type | Individual
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Provider Name | JENNIFER KARINA BASULTO MSW, ASW
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Gender | Female
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Dates
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Enumeration Date | 09/08/2021
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 14535 WHITTIER BLVD
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City | WHITTIER
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State | CA
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Zip | 90605-2130
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Country | US
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Telephone | 562-907-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 1041 GILWOOD AVE
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City | LA PUENTE
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State | CA
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Zip | 91744-2122
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Country | US
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Telephone | 626-465-6920
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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 | 108825
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License Number State | CA
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