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1720155799
MICHAEL P BASTA
SONOMA, CA
NPI
1720155799
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CA LCS12967)
Enumeration Date
2006-11-29
Last Update Date
2007-07-08
Business Address
Mr. MICHAEL P BASTA MSW
793 1ST ST W
SONOMA, CA 95476-7036
Phone number: 707-935-6739
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Mailing Address
Mr. MICHAEL P BASTA MSW
PO BOX 957
GLEN ELLEN, CA 95442-0957
Phone number: 707-935-6739
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