MEDICARE: DR. JAMES BYLUND

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TS0200X	School Psychologist	B7027424	CA

General Provider Information

NPI Number	:	1861921744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES BYLUND

Provider Business Mailing Address
First Line	:	756 MARJORAM DR
Second Line	:
City	:	BRENTWOOD
State	:	CA
Zip	:	94513-5178
Country	:	US
Telephone Number	:	925-788-9264
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 SAND CREEK RD STE G-5
Second Line	:
City	:	BRENTWOOD
State	:	CA
Zip	:	94513-2124
Country	:	US
Telephone Number	:	925-303-7054
Fax Number	:	925-303-7054

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2017
Last Update Date	:	06/05/2017

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