Provider Demographics
NPI:1710443999
Name:BAYLEY, ELIZABETH CLARE (MS)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CLARE
Last Name:BAYLEY
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 1:635 CALLE ARROYO
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-2577
Mailing Address - Country:US
Mailing Address - Phone:805-558-3347
Mailing Address - Fax:
Practice Address - Street 1:5675 W OLYMPIC BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4712
Practice Address - Country:US
Practice Address - Phone:323-965-1365
Practice Address - Fax:323-965-0444
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program