Healthcare Provider Details

I. General information

NPI: 1285442954
Provider Name (Legal Business Name): OJAYA BAILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2024
Last Update Date: 12/26/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2227 CAPRICORN WAY STE 211
SANTA ROSA CA
95407-5486
US

IV. Provider business mailing address

10730 ATWOOD DR
RANCHO CORDOVA CA
95670-4907
US

V. Phone/Fax

Practice location:
  • Phone: 707-565-4700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number705244
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: