Provider Demographics
NPI:1609619931
Name:BAILEY, ROBIN LYNN SR
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:LYNN
Last Name:BAILEY
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7210 MURRAY DR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95210-3339
Mailing Address - Country:US
Mailing Address - Phone:669-335-7701
Mailing Address - Fax:
Practice Address - Street 1:7912 WEST LN STE 221
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210-3159
Practice Address - Country:US
Practice Address - Phone:209-636-5000
Practice Address - Fax:209-762-6959
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker