Healthcare Provider Details

I. General information

NPI: 1144839531
Provider Name (Legal Business Name): MEGHAN BAKER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2020
Last Update Date: 08/29/2025
Certification Date: 08/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43360 MISSION BLVD STE 100
FREMONT CA
94539-5959
US

IV. Provider business mailing address

10455 S DE ANZA BLVD
CUPERTINO CA
95014-3011
US

V. Phone/Fax

Practice location:
  • Phone: 510-992-4114
  • Fax: 844-889-0275
Mailing address:
  • Phone: 505-980-1929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95013697
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: