Provider Demographics
NPI:1174833909
Name:BASKETT, JAMIE SU (MSW, LCSW)
Entity Type:Individual
Prefix:MISS
First Name:JAMIE
Middle Name:SU
Last Name:BASKETT
Suffix:
Gender:F
Credentials:MSW, LCSW
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Mailing Address - Street 1:1761 BROADWAY ST STE 100
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94589-2227
Mailing Address - Country:US
Mailing Address - Phone:707-645-2700
Mailing Address - Fax:707-645-2181
Practice Address - Street 1:1761 BROADWAY ST STE 100
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2227
Practice Address - Country:US
Practice Address - Phone:707-645-2700
Practice Address - Fax:707-645-2181
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical