MEDICARE: MS. KRISTIN RYAN BAUGHMAN MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT 8539	CA

General Provider Information

NPI Number	:	1073898276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KRISTIN RYAN BAUGHMAN MA

Provider Business Mailing Address
First Line	:	1809B MORGAN LN
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-4831
Country	:	US
Telephone Number	:	310-908-3673
Fax Number	:	310-424-7338

Provider Business Practice Location Address
First Line	:	1809 MORGAN LN # B
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-4831
Country	:	US
Telephone Number	:	310-908-3673
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2011
Last Update Date	:	09/16/2025

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