MEDICARE: CHRISTIE BAKER

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1154029486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIE BAKER

Provider Business Mailing Address
First Line	:	10907 MAGNOLIA BLVD UNIT 314
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-3904
Country	:	US
Telephone Number	:	818-471-7687
Fax Number	:

Provider Business Practice Location Address
First Line	:	10907 MAGNOLIA BLVD UNIT 314
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-3904
Country	:	US
Telephone Number	:	818-471-7687
Fax Number	:

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

Provider Enumeration Date	:	02/16/2023
Last Update Date	:	02/16/2023

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Directions to “ CHRISTIE BAKER ” Practice Location

Language	Start Address	Practice Location

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