Healthcare Provider Details

I. General information

NPI: 1861314395
Provider Name (Legal Business Name): MR. AUSTEN KEITH BAKER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10345 PROFESSIONAL CIR STE 125A
RENO NV
89521-3100
US

IV. Provider business mailing address

6210 MATTERHORN BLVD
RENO NV
89506-5419
US

V. Phone/Fax

Practice location:
  • Phone: 775-348-7300
  • Fax:
Mailing address:
  • Phone: 775-813-4875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: