Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | LEP3005 | CA |
NPI | 1093287864 |
---|---|
Provider Name | Ms. Barbara E. Baker |
First Address | Hayward, CA 94541-4511 |
Second Address | Hayward, CA 94544-1136 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2018 |
Last Update Date | 18/12/2018 |