Healthcare Provider Details

I. General information

NPI: 1982518775
Provider Name (Legal Business Name): MANDAH BAUGHMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 912
FOREST RANCH CA
95942-0912
US

IV. Provider business mailing address

PO BOX 912
FOREST RANCH CA
95942-0912
US

V. Phone/Fax

Practice location:
  • Phone: 530-570-6937
  • Fax:
Mailing address:
  • Phone: 530-570-6937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number733257
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: