Healthcare Provider Details

I. General information

NPI: 1235068867
Provider Name (Legal Business Name): RONDALYN JEWEL BAILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16558 PAINE ST UNIT 2
FONTANA CA
92336-2778
US

IV. Provider business mailing address

16558 PAINE ST UNIT 2
FONTANA CA
92336-2778
US

V. Phone/Fax

Practice location:
  • Phone: 840-217-6332
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number002305452
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: