Provider Demographics
NPI:1871856435
Name:BASSFORD, RILEY (MSW)
Entity type:Individual
Prefix:
First Name:RILEY
Middle Name:
Last Name:BASSFORD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S MAIN ST STE 1100
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4513
Mailing Address - Country:US
Mailing Address - Phone:714-955-6574
Mailing Address - Fax:
Practice Address - Street 1:500 S MAIN ST STE 1100
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4513
Practice Address - Country:US
Practice Address - Phone:714-955-6574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator