Healthcare Provider Details

I. General information

NPI: 1588507073
Provider Name (Legal Business Name): BAILEY E WALKER RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10544 SPENCEVILLE RD
PENN VALLEY CA
95946-9623
US

IV. Provider business mailing address

10544 SPENCEVILLE RD
PENN VALLEY CA
95946-9623
US

V. Phone/Fax

Practice location:
  • Phone: 530-274-9762
  • Fax: 530-273-7255
Mailing address:
  • Phone: 530-274-9762
  • Fax: 530-273-7255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberRDH37248
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: