Healthcare Provider Details

I. General information

NPI: 1467975656
Provider Name (Legal Business Name): BAYS NURSING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2017
Last Update Date: 07/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3433 MARATHON DR
SAN DIEGO CA
92123-2621
US

IV. Provider business mailing address

3433 MARATHON DR
SAN DIEGO CA
92123-2621
US

V. Phone/Fax

Practice location:
  • Phone: 858-336-6932
  • Fax:
Mailing address:
  • Phone: 858-336-6932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number266851
License Number StateCA

VIII. Authorized Official

Name: MS. GABRIELLE ANN BAYS
Title or Position: CEO
Credential: NP
Phone: 858-336-6932