Individual
KELLY BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, ATC
Contact information
Practice address
1621 LARCO WAY, GLENDALE, CA 91202-1325
(818) 321-9949
Mailing address
1621 LARCO WAY, GLENDALE, CA 91202-1325
(818) 321-9949
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/14/2014
Last updated
06/17/2026
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