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1063335644 NPI number — KASIDEE NICOLE BAKER MS CCC-SLP

NPI Number: 1063335644
Health Care Provider/Practitioner: KASIDEE NICOLE BAKER MS CCC-SLP

Information about “1063335644” NPI (KASIDEE NICOLE BAKER MS CCC-SLP) exists in 1063335644 in HTML format HTML  |  1063335644 in plain Text format TXT  |  1063335644 in PDF (Portable Document Format) PDF  |  1063335644 in an XML format XML  formats.

NPI Number : 1063335644 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1063335644",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BAKER",
    "FirstName": "KASIDEE",
    "MiddleName": "NICOLE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MS CCC-SLP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "PASCOE",
    "OtherFirstName": "KASIDEE",
    "OtherMiddleName": "NICOLE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MS CCC-SLP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "2801 MAIN ST APT 454",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "IRVINE",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92614-5022",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "530-402-5591",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1051 W BASTANCHURY RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FULLERTON",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92833-2247",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "714-870-2870",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/31/2026",
    "LastUpdateDate": "07/31/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "235Z00000X",
        "TaxonomyName": "Speech-Language Pathologist",
        "LicenseNumber": "40453",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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