MEDICARE: BASSI PSYCHOLOGICAL SERVICES INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	106H00000X	Marriage & Family Therapist
3	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1588188262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BASSI PSYCHOLOGICAL SERVICES INC

Provider Business Mailing Address
First Line	:	2200 PACIFIC COAST HWY STE 302
Second Line	:
City	:	HERMOSA BEACH
State	:	CA
Zip	:	90254-2702
Country	:	US
Telephone Number	:	310-946-7660
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 PACIFIC COAST HWY STE 302
Second Line	:
City	:	HERMOSA BEACH
State	:	CA
Zip	:	90254-2702
Country	:	US
Telephone Number	:	310-946-7660
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SEPIDEH BASSI
Credential	:	PSY.D.
Telephone Number	:	310-946-7660

Provider Enumeration Date	:	08/03/2017
Last Update Date	:	08/25/2023

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