Provider Demographics
NPI:1447433156
Name:BASCOS, JACQUELINE STRACHAN
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:STRACHAN
Last Name:BASCOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 E PALMDALE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-4957
Mailing Address - Country:US
Mailing Address - Phone:661-232-3838
Mailing Address - Fax:661-537-2935
Practice Address - Street 1:2323 E PALMDALE BLVD STE A
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-4957
Practice Address - Country:US
Practice Address - Phone:661-232-3838
Practice Address - Fax:661-537-2935
Is Sole Proprietor?:No
Enumeration Date:2007-12-17
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator