Provider Demographics
NPI:1285896431
Name:BASSATT-WINCHELL, JANE M (LCSW)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:M
Last Name:BASSATT-WINCHELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5492 TYHURST WALKWAY APT 2
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-1861
Mailing Address - Country:US
Mailing Address - Phone:585-255-0512
Mailing Address - Fax:
Practice Address - Street 1:2542 S BASCOM AVE STE 110
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-5541
Practice Address - Country:US
Practice Address - Phone:408-559-3403
Practice Address - Fax:408-559-3158
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW706271041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker