Individual
SHELLY BAESLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
924 PROCK ST, POMONA, CA 91768-2054
(909) 620-9715
Mailing address
924 PROCK ST, POMONA, CA 91768-2054
(909) 620-9715
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C013520
LADMH STAFF CODE
CA
01
—
ICAN670
DMH STAFF CODE
CA
Enumeration date
03/15/2007
Last updated
04/15/2008
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