Provider Demographics
NPI:1134130917
Name:SASSIN, JON F (MD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:F
Last Name:SASSIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:855 BORDEAUX WAY
Mailing Address - Street 2:#220
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558
Mailing Address - Country:US
Mailing Address - Phone:707-252-8400
Mailing Address - Fax:707-252-4700
Practice Address - Street 1:855 BORDEAUX WAY
Practice Address - Street 2:#220
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-7549
Practice Address - Country:US
Practice Address - Phone:707-252-8400
Practice Address - Fax:707-252-4700
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC304212084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA34257Medicare UPIN
CA00C304210Medicare ID - Type Unspecified