Healthcare Provider Details

I. General information

NPI: 1487589685
Provider Name (Legal Business Name): JOHN ERIC BAKER-AIDUKAS SLP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39000 BOB HOPE DR
RANCHO MIRAGE CA
92270-3202
US

IV. Provider business mailing address

68636 PASADA RD
CATHEDRAL CITY CA
92234-4853
US

V. Phone/Fax

Practice location:
  • Phone: 760-834-7882
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number8745
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: