MEDICARE: MR. ANDREW NEIL BAILEY SUD RC

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	24637	CA

General Provider Information

NPI Number	:	1821948985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANDREW NEIL BAILEY SUD RC

Provider Business Mailing Address
First Line	:	7240 EL CAJON BLVD APT 15
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-1800
Country	:	US
Telephone Number	:	417-414-9119
Fax Number	:

Provider Business Practice Location Address
First Line	:	6950 EL CAJON BLVD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-1738
Country	:	US
Telephone Number	:	619-439-2473
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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