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DR. JASON M. BAILIE PH.D.
>> Clinical Neuropsychologist >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1932494432
Individual Registrant:DR. JASON M. BAILIE PH.D.
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
3102 E HIGHLAND AVE PATTON, CA 92369-7813 US
Tel: 909-425-7658 Fax: --
Tel: 909-425-7658 Fax: --
Contact information for business:
3102 E HIGHLAND AVE PATTON, CA 92369-7813 US
Tel: 909-425-7658 Fax: --
Tel: 909-425-7658 Fax: --
Registration Information:
NPI: 1932494432
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | CA | 24126 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
