Healthcare Provider Details

I. General information

NPI: 1811802739
Provider Name (Legal Business Name): JOSEPH BAKER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15477 VENTURA BLVD
SHERMAN OAKS CA
91403-3006
US

IV. Provider business mailing address

600 FIRESTONE AVE APT 1516
MUSCLE SHOALS AL
35661-6484
US

V. Phone/Fax

Practice location:
  • Phone: 760-835-4213
  • Fax:
Mailing address:
  • Phone: 256-668-2562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-141700
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95053011
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: