MEDICARE: JENNIFER BASURTO

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TS0200X	School Psychologist

General Provider Information

NPI Number	:	1447194014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER BASURTO

Provider Business Mailing Address
First Line	:	450 HARVARD AVE APT 1P
Second Line	:
City	:	SANTA CLARA
State	:	CA
Zip	:	95051-6441
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1750 S WHITE RD
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95127-4760
Country	:	US
Telephone Number	:	408-673-4892
Fax Number	:

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

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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Directions to “ JENNIFER BASURTO ” Practice Location

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