Individual
MRS. DONNA BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
116 SANDY HILL CT., CALIMESA, CA 92320
(909) 795-8580
Mailing address
116 SANDY HILL CT., CALIMESA, CA 92320
(909) 795-8580
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT30169
CA
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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