Provider Demographics
NPI:1457621096
Name:BAILEY, JAMES GARRETT (DPT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:GARRETT
Last Name:BAILEY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 VICTORIA WAY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-5326
Mailing Address - Country:US
Mailing Address - Phone:661-809-0408
Mailing Address - Fax:
Practice Address - Street 1:365 S RANCHO SANTA FE RD
Practice Address - Street 2:SUITE 205
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-2338
Practice Address - Country:US
Practice Address - Phone:661-809-0408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38522225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist