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NPI Code Detail

MEDICARE: MS. NAKISHA L BAILEY MFT-1

MEDICARE:  MS. NAKISHA L BAILEY  MFT-1
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
1106H00000XMarriage & Family Therapist53172CA

General Provider Information

NPI Number : 1659564177
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NAKISHA L BAILEY MFT-1
Provider Business Mailing Address
First Line : 6201 ENTERPRISE DR STE C
Second Line :
City : DIAMOND SPRINGS
State : CA
Zip : 95619-9482
Country : US
Telephone Number : 530-295-3715
Fax Number : 530-295-3795
Provider Business Practice Location Address
First Line : 6201 ENTERPRISE DR STE C
Second Line :
City : DIAMOND SPRINGS
State : CA
Zip : 95619-9482
Country : US
Telephone Number : 530-295-3715
Fax Number : 530-295-3795
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2007
Last Update Date : 08/20/2007

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Directions to “ MS. NAKISHA L BAILEY MFT-1” Practice Location

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