Provider Demographics
NPI:1427860360
Name:BASTIO, CHARVI BHASIN (AMFT)
Entity type:Individual
Prefix:
First Name:CHARVI
Middle Name:BHASIN
Last Name:BASTIO
Suffix:
Gender:
Credentials:AMFT
Other - Prefix:
Other - First Name:CHARVI
Other - Middle Name:
Other - Last Name:BHASIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4016 GRAND AVE
Mailing Address - Street 2:SUITE A #1005
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710
Mailing Address - Country:US
Mailing Address - Phone:949-316-7800
Mailing Address - Fax:
Practice Address - Street 1:2009 PALO VERDE AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-3322
Practice Address - Country:US
Practice Address - Phone:714-482-3414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA149910106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist