Healthcare Provider Details

I. General information

NPI: 1942330444
Provider Name (Legal Business Name): DONNA M. BALDWIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 ALEXIAN DR
SAN JOSE CA
95116-1901
US

IV. Provider business mailing address

34216 GADWALL CMN
FREMONT CA
94555-3001
US

V. Phone/Fax

Practice location:
  • Phone: 408-272-6518
  • Fax:
Mailing address:
  • Phone: 510-791-2658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLCS18649
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: