| Doctor Name: | JAMES BIVINS |
| NPI Number: | 1194121590 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | NURSE PRACTITIONER |
| License Number: | 95001284 |
| Business Practice Address: | 1145 Sturgis Rd Twentynine Palms, CA - 92278 |
| Business Phone Number: | 7608302724 |
| Business Fax Number: | |
| Mailing Address: | 78421 Orcabessa Dr, BERMUDA DUNES |
| State: | CA |
| Postal Code: | 922031078 |
| Phone Number: | 9515518402 |
| Fax Number: | |
| NPI Enumeration Date: | 11/12/2014 |
| NPI Last Update Date: | 11/12/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | 95001284 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |