Provider Demographics
NPI:1750118113
Name:BAYLON, BIANCA LIGGAYU (FNP)
Entity type:Individual
Prefix:MS
First Name:BIANCA
Middle Name:LIGGAYU
Last Name:BAYLON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7943 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92114-7315
Mailing Address - Country:US
Mailing Address - Phone:619-888-4916
Mailing Address - Fax:
Practice Address - Street 1:7344 IRONDALE AVE
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:CA
Practice Address - Zip Code:91306-2716
Practice Address - Country:US
Practice Address - Phone:619-888-4916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95031841363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily