Healthcare Provider Details

I. General information

NPI: 1740774629
Provider Name (Legal Business Name): DR. SYNNE BAKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2018
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3580 WILSHIRE BLVD STE 2000
LOS ANGELES CA
90010-2533
US

IV. Provider business mailing address

315 E 8TH ST APT 903
LOS ANGELES CA
90014-2236
US

V. Phone/Fax

Practice location:
  • Phone: 213-381-1250
  • Fax: 213-383-4803
Mailing address:
  • Phone: 323-241-2404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY36669
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: