Provider Demographics
NPI:1619502119
Name:BAYLES, DEBORAH LEIGH (LMFT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LEIGH
Last Name:BAYLES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3940 BROAD ST # 7320
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-7017
Mailing Address - Country:US
Mailing Address - Phone:805-931-6001
Mailing Address - Fax:
Practice Address - Street 1:301 S MILLER ST STE 121
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5243
Practice Address - Country:US
Practice Address - Phone:805-925-5470
Practice Address - Fax:805-922-3263
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-05
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA136264106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist