Provider Demographics
NPI:1588546352
Name:BAYLESS, JOSHUA DANIEL (RB)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:DANIEL
Last Name:BAYLESS
Suffix:
Gender:M
Credentials:RB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 N OREM BLVD
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-6601
Mailing Address - Country:US
Mailing Address - Phone:801-691-0672
Mailing Address - Fax:801-691-0673
Practice Address - Street 1:234 N OREM BLVD
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-6601
Practice Address - Country:US
Practice Address - Phone:801-691-0672
Practice Address - Fax:801-691-0673
Is Sole Proprietor?:No
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9443275-3102163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)