| Doctor Name: | MS. DANA EMERSON BASU |
| NPI Number: | 1023267549 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSYD |
| License Number: | PSY24579 |
| Business Practice Address: | 2549 Eastbluff Dr # 134 Newport Beach, CA - 926603500 |
| Business Phone Number: | 6085752111 |
| Business Fax Number: | 9492207004 |
| Mailing Address: | 2549 Eastbluff Dr # 134, NEWPORT BEACH |
| State: | CA |
| Postal Code: | 926603500 |
| Phone Number: | 6085752111 |
| Fax Number: | 9492207004 |
| NPI Enumeration Date: | 09/09/2008 |
| NPI Last Update Date: | 11/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY24579 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |