MEDICARE: MS. ANASUYA BASIL NC, DIPL. ABT, CST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	174H00000X	Health Educator
2	225700000X	Massage Therapist
3	133NN1002X	Nutrition Education Nutritionist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2467	OTHER		AMERICAN ORGANIZATION OF BODYWORK THERAPIES OF ASIA MEMBER ID
2	24833	OTHER		NATIONAL CERTIFICATION COMMISSION FOR ACUPUNCTURE AND ORIENTAL MED, DIPL. ABT
3	20055	OTHER	CA	NATIONAL ASSOCIATION OF NUTRITION PROFESSIONALS PROF MEMBER ID
4	104192	OTHER	CA	CALIFORNIA MASSAGE THERAPY BOARD ID

General Provider Information

NPI Number	:	1336626381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANASUYA BASIL NC, DIPL. ABT, CST

Provider Business Mailing Address
First Line	:	PO BOX 609
Second Line	:
City	:	FOREST RANCH
State	:	CA
Zip	:	95942-0609
Country	:	US
Telephone Number	:	510-848-8439
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 WILLIAMSBURG LN STE B
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95926-2297
Country	:	US
Telephone Number	:	510-848-8439
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2018
Last Update Date	:	07/23/2018

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