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General NPI Number Information
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NPI Number | 1841837002
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Entity Type | Organization
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Legal Business Name | JENNIFER BAILEY, PSY.D., A PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 12/06/2019
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Last Update Date | 12/06/2019
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Provider Practice Location Address
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Address Line | 1601 CARMEN DR STE 215-I
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City | CAMARILLO
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State | CA
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Zip | 93010-3105
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Country | US
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Telephone | 805-637-8090
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 CARMEN DR STE 215-I
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City | CAMARILLO
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State | CA
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Zip | 93010-3105
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Country | US
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Telephone | 805-637-8090
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Fax |
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Authorized Official
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Title or Position | CEO AND PRESIDENT
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Name | DR. JENNIFER A. BAILEY
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Credential | PSY.D.
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Telephone | 805-637-8090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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