Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 561772 | CA |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 14399 | CA |
NPI | 1164592408 |
---|---|
Provider Name | Julia K Bail |
First Address | Santa Clarita, CA 91350-2118 |
Second Address | Los Angeles, CA 90095-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 29/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q75366 | (02) | CA |
RN561772 | (05) | CA |