Provider Demographics
NPI:1215629480
Name:BASTA, MESSINA DOVICHI (LCSW)
Entity type:Individual
Prefix:
First Name:MESSINA
Middle Name:DOVICHI
Last Name:BASTA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MESSINA
Other - Middle Name:ATHENA
Other - Last Name:DOVICHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:413 COMSTOCK WAY
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-3128
Mailing Address - Country:US
Mailing Address - Phone:707-631-6010
Mailing Address - Fax:
Practice Address - Street 1:2830 I ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-4311
Practice Address - Country:US
Practice Address - Phone:916-250-0542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-24
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1325701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical