Provider Demographics
NPI:1073898276
Name:BAUGHMAN, KRISTIN RYAN (MA)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:RYAN
Last Name:BAUGHMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809B MORGAN LN
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-4831
Mailing Address - Country:US
Mailing Address - Phone:310-908-3673
Mailing Address - Fax:310-424-7338
Practice Address - Street 1:1809 MORGAN LN # B
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-4831
Practice Address - Country:US
Practice Address - Phone:310-908-3673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 8539225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist