Healthcare Provider Details

I. General information

NPI: 1902649726
Provider Name (Legal Business Name): SHANAI L BAILEY RN, LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2024
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 WORKMAN ST
BAKERSFIELD CA
93307-6800
US

IV. Provider business mailing address

718 WORKMAN ST
BAKERSFIELD CA
93307-6800
US

V. Phone/Fax

Practice location:
  • Phone: 661-335-7100
  • Fax:
Mailing address:
  • Phone: 661-335-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number95347085
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95347085
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: