Individual provider Active NPI

Lynette Eve Bassman, PH.D.

  • Psychologist
  • Clovis, CA
National Provider Identifier
1649201500
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY16362 Issued in CA
Practice address
255 W Bullard Ave
Ste 101
Clovis, CA 93612-0861
Phone
(559) 549-4989
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY16362 CA Primary

Addresses

Primary practice location

255 W Bullard Ave
Ste 101
Clovis, CA 93612-0861

Mailing address

2740 Herndon Ave
Clovis, CA 93611-6813
Phone (559) 299-4264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY16362CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Valley Indian Health, Inc. CurrentSince Feb 22, 2016 Accepting new patients
Central Valley Indian Health Inc Current Accepting new patients
Alliant International University Past Accepting new patients
Gary S. Cannyon Psychological Service Center Past Accepting new patients

Locations

2740 Herndon Ave
Clovis, CA 93611
Phone (559) 299-2608

29369 Auberry Rd
Ste 102
Prather, CA 93651
Phone (559) 855-5390

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1649201500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 HERNDON AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116813",
            "telephone_number": "559-299-4264",
            "fax_number": "559-299-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W BULLARD AVE",
            "address_2": "STE 101",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936120861",
            "telephone_number": "559-549-4989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSMAN",
        "first_name": "LYNETTE",
        "middle_name": "EVE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY16362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

Verify at the official NPI Registry.