Provider Demographics
NPI:1033395173
Name:BAKER, DAUN ELAINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAUN
Middle Name:ELAINE
Last Name:BAKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE 314
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-2434
Mailing Address - Country:US
Mailing Address - Phone:310-395-3895
Mailing Address - Fax:310-459-4153
Practice Address - Street 1:506 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 314
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-2434
Practice Address - Country:US
Practice Address - Phone:310-395-3895
Practice Address - Fax:310-459-4153
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-19
Last Update Date:2008-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 13398103TC0700X
CAMFC23827106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist