MEDICARE: BRITTNEY BAISDEN MA, PPS

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	103TS0200X	School Psychologist	240161247	CA

General Provider Information

NPI Number	:	1629885942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTNEY BAISDEN MA, PPS

Provider Business Mailing Address
First Line	:	360 NEVADA ST
Second Line	:
City	:	AUBURN
State	:	CA
Zip	:	95603-3720
Country	:	US
Telephone Number	:	916-517-5569
Fax Number	:

Provider Business Practice Location Address
First Line	:	360 NEVADA ST
Second Line	:
City	:	AUBURN
State	:	CA
Zip	:	95603-3720
Country	:	US
Telephone Number	:	916-517-5569
Fax Number	:

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

Provider Enumeration Date	:	12/11/2024
Last Update Date	:	12/11/2024

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