Provider Demographics
NPI:1619855525
Name:BAIL, JACELINE AURITA
Entity type:Individual
Prefix:
First Name:JACELINE
Middle Name:AURITA
Last Name:BAIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2768 BOWHILL LN
Mailing Address - Street 2:
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-3150
Mailing Address - Country:US
Mailing Address - Phone:415-610-9179
Mailing Address - Fax:
Practice Address - Street 1:325 BISSELL AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94801-3041
Practice Address - Country:US
Practice Address - Phone:415-610-9179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician