Individual
SCOTT L BAYLESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1844 SCENIC DR APT 239, MODESTO, CA 95355-6026
(209) 227-4689
(209) 227-2326
Mailing address
PO BOX 579048, MODESTO, CA 95357-9048
(209) 274-6892
(209) 267-2326
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
PSY13401
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922005107
NO OTHER IDENTIFIERS
CA
01
—
PSY13401
STATE LICENSE
CA
Enumeration date
07/04/2005
Last updated
02/22/2022
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