Healthcare Provider Details

I. General information

NPI: 1467542159
Provider Name (Legal Business Name): BRIDGETT SAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17973 LOST CANYON RD #86
CANYON COUNTRY CA
91387-8288
US

IV. Provider business mailing address

17973 LOST CANYON RD #86
CANYON COUNTRY CA
91387-8288
US

V. Phone/Fax

Practice location:
  • Phone: 818-907-7828
  • Fax:
Mailing address:
  • Phone: 818-907-7828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number11952
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: