Provider Demographics
NPI:1831230085
Name:BASS, CAROLYN JANE
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:JANE
Last Name:BASS
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 1:1827 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-2003
Mailing Address - Country:US
Mailing Address - Phone:661-246-5049
Mailing Address - Fax:
Practice Address - Street 1:1721 WESTWIND DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3026
Practice Address - Country:US
Practice Address - Phone:661-868-8268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator