Individual
KRYSTLE BAGBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15095 AMARGOSA RD, VICTORVILLE, CA 92394-1879
(626) 404-3253
Mailing address
15095 AMARGOSA RD, VICTORVILLE, CA 92394-1879
(626) 404-3253
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
05/14/2024
Last updated
04/10/2025
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