Provider Demographics
NPI:1861921744
Name:BYLUND, JAMES
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:BYLUND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:756 MARJORAM DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-5178
Mailing Address - Country:US
Mailing Address - Phone:925-788-9264
Mailing Address - Fax:
Practice Address - Street 1:201 SAND CREEK RD STE G-5
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-2124
Practice Address - Country:US
Practice Address - Phone:925-303-7054
Practice Address - Fax:925-303-7054
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2017-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB7027424103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool