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General NPI Number Information
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NPI Number | 1235015876
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Entity Type | Individual
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Provider Name | JUDITH MARIE BAKER
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Gender | Female
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Dates
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Enumeration Date | 08/11/2025
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 302 N EL CAMINO REAL
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City | SAN CLEMENTE
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State | CA
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Zip | 92672-4775
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Country | US
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Telephone | 949-212-3266
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 PAHLS WAY
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City | RAMONA
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State | CA
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Zip | 92065-1220
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Country | US
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Telephone | 720-202-1402
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | APCC18664
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License Number State | CA
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