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Individual

BAILEY BORUP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
844 PICO BLVD, SANTA MONICA, CA 90405-1325
(310) 314-6200
Mailing address
139 MACADEMIA LN, SIMI VALLEY, CA 93065-6914

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1041C0700X
Clinical Social Worker
Primary
105149
CA
247200000X
Other Technician
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
07/06/2018
Last updated
09/16/2025
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