Provider Demographics
NPI:1427593151
Name:BAYLIS, BRITTNEE (MS)
Entity Type:Individual
Prefix:
First Name:BRITTNEE
Middle Name:
Last Name:BAYLIS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 RIDGEGATE DR. STE 200
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-5506
Mailing Address - Country:US
Mailing Address - Phone:951-466-3196
Mailing Address - Fax:
Practice Address - Street 1:1 RIDGEGATE DR STE 200
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-5506
Practice Address - Country:US
Practice Address - Phone:951-466-3196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-04
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD6299638106S00000X
CA1-22-61260103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician