Scott L Bayless, PH.D.

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

PSY13401 Issued in CA

Practice address

1844 Scenic Dr Apt 239
Modesto, CA 95355-6026

Phone

(209) 227-4689

Fax

(209) 227-2326

NPI assigned

Jul 4, 2005

Reactivated

Apr 6, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1922005107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 579048",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953579048",
            "telephone_number": "209-274-6892",
            "fax_number": "209-267-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1844 SCENIC DR APT 239",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953556026",
            "telephone_number": "209-227-4689",
            "fax_number": "209-227-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYLESS",
        "first_name": "SCOTT",
        "middle_name": "L",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-04",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY13401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NO OTHER IDENTIFIERS",
            "identifier": "1922005107",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PSY13401",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cognitive & Behavioral Psychologist in Modesto, CA
• Providers in Modesto, CA by specialty
• Cognitive & Behavioral Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.