Healthcare Provider Details

I. General information

NPI: 1669857736
Provider Name (Legal Business Name): CHRISTINE MARIE BAKER LVN,CPT 1, RMA (AMT)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date: 10/22/2024
Reactivation Date: 11/04/2024

III. Provider practice location address

550 N FLOWER ST
SANTA ANA CA
92703-2361
US

IV. Provider business mailing address

3832 HOWARD AVE APT 1
LOS ALAMITOS CA
90720-3626
US

V. Phone/Fax

Practice location:
  • Phone: 714-647-4172
  • Fax:
Mailing address:
  • Phone: 562-810-6828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberCPT00050184
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number742568
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: