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NPI Code Detail

MEDICARE: MADELINE D BAILEY

MEDICARE:   MADELINE D BAILEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1184296949
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELINE D BAILEY
Provider Business Mailing Address
First Line : 2015 LINCOLN WAY APT 1
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94122-1740
Country : US
Telephone Number : 510-754-9085
Fax Number :
Provider Business Practice Location Address
First Line : 2015 LINCOLN WAY APT 1
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94122-1740
Country : US
Telephone Number : 510-754-9085
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2021
Last Update Date : 07/12/2021

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Directions to “ MADELINE D BAILEY ” Practice Location

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