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General NPI Number Information
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NPI Number | 1588933253
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Entity Type | Organization
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Legal Business Name | BETH BAUMEISTER, PH.D.
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Dates
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Enumeration Date | 12/23/2011
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Last Update Date | 12/23/2011
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Provider Practice Location Address
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Address Line | 1546 CALLE HONDANADA
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-6825
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Country | US
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Telephone | 626-221-6187
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Fax | 626-221-6187
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Provider Business Mailing Address
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Address Line | 2239 TOWNSGATE RD SUITE 107
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-2405
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Country | US
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Telephone | 626-221-6187
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Fax | 626-221-6187
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Authorized Official
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Title or Position | OWNER
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Name | DR. BETH MICHELLE BAUMEISTER
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Credential | PH.D.
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Telephone | 626-221-6187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY20565
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License Number State | CA
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