MEDICARE: LASHA 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	3747P1801X	Personal Care Attendant
2	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1205179603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LASHA BAKER

Provider Business Mailing Address
First Line	:	8445 LAS VEGAS BLVD S APT 2025
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1695
Country	:	US
Telephone Number	:	702-472-5801
Fax Number	:

Provider Business Practice Location Address
First Line	:	8445 LAS VEGAS BLVD S APT 2025
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1695
Country	:	US
Telephone Number	:	702-472-5801
Fax Number	:

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

Provider Enumeration Date	:	04/03/2013
Last Update Date	:	02/19/2025

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Directions to “ LASHA BAKER ” Practice Location

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