Provider Demographics
NPI:1104052745
Name:BAYSA, CATHERINE CABISUDO (DMD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:CABISUDO
Last Name:BAYSA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 REDWOOD ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-3603
Mailing Address - Country:US
Mailing Address - Phone:707-334-3728
Mailing Address - Fax:
Practice Address - Street 1:2121 REDWOOD ST
Practice Address - Street 2:SUITE B
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-3603
Practice Address - Country:US
Practice Address - Phone:707-334-3728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA508881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice