MEDICARE: DR. DAUN ELAINE BAKER PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY 13398	CA
2	106H00000X	Marriage & Family Therapist	MFC23827	CA

General Provider Information

NPI Number	:	1033395173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAUN ELAINE BAKER PH.D.

Provider Business Mailing Address
First Line	:	506 SANTA MONICA BLVD
Second Line	:	SUITE 314
City	:	SANTA MONICA
State	:	CA
Zip	:	90401-2434
Country	:	US
Telephone Number	:	310-395-3895
Fax Number	:	310-459-4153

Provider Business Practice Location Address
First Line	:	506 SANTA MONICA BLVD
Second Line	:	SUITE 314
City	:	SANTA MONICA
State	:	CA
Zip	:	90401-2434
Country	:	US
Telephone Number	:	310-395-3895
Fax Number	:	310-459-4153

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2008
Last Update Date	:	01/19/2008

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