Provider Demographics
NPI:1841837002
Name:JENNIFER BAILEY, PSY.D., A PSYCHOLOGICAL CORPORATION
Entity type:Organization
Organization Name:JENNIFER BAILEY, PSY.D., A PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:805-637-8090
Mailing Address - Street 1:1601 CARMEN DR STE 215-I
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-3105
Mailing Address - Country:US
Mailing Address - Phone:805-637-8090
Mailing Address - Fax:
Practice Address - Street 1:1601 CARMEN DR STE 215-I
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-3105
Practice Address - Country:US
Practice Address - Phone:805-637-8090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-06
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty