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General NPI Number Information
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NPI Number | 1942039839
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Entity Type | Individual
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Provider Name | ALEXIS TAYLOR BAKER AMFT
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Gender | Female
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Dates
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Enumeration Date | 07/29/2024
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 452 S AUBURN ST
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City | GRASS VALLEY
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State | CA
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Zip | 95945-7235
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Country | US
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Telephone | 530-913-7221
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Fax |
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Provider Business Mailing Address
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Address Line | 417 MANZANITA WAY
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City | COLFAX
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State | CA
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Zip | 95713-9201
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Country | US
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Telephone |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 146453
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License Number State | CA
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