Provider Demographics
NPI:1508391327
Name:BAYONN, GERARD
Entity Type:Individual
Prefix:
First Name:GERARD
Middle Name:
Last Name:BAYONN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4524 CHINA ROSE CIR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-7740
Mailing Address - Country:US
Mailing Address - Phone:775-771-0158
Mailing Address - Fax:
Practice Address - Street 1:2696 BERTINI CT
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-2046
Practice Address - Country:US
Practice Address - Phone:775-771-0158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-30
Last Update Date:2017-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst