Healthcare Provider Details

I. General information

NPI: 1770615304
Provider Name (Legal Business Name): GEORGIA BAKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44443 10TH ST W
LANCASTER CA
93534-3324
US

IV. Provider business mailing address

43646 FIG AVE
LANCASTER CA
93534-4909
US

V. Phone/Fax

Practice location:
  • Phone: 661-726-2630
  • Fax: 661-952-1030
Mailing address:
  • Phone: 661-726-2630
  • Fax: 661-952-1030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: