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General NPI Number Information
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NPI Number | 1710335344
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Entity Type | Organization
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Legal Business Name | CYNTHIA BAKER, PHD
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Dates
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Enumeration Date | 05/24/2016
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Last Update Date | 05/24/2016
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Provider Practice Location Address
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Address Line | 1001 DOVE ST STE 280
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-2815
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Country | US
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Telephone | 949-923-8961
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 DOVE ST STE 280
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-2815
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Country | US
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Telephone | 949-923-8961
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CYNTHIA BAKER
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Credential | PH.D
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Telephone | 949-923-8961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMF 75966
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY18435
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License Number State | CA
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