Provider Demographics
NPI:1083249494
Name:BAKER, LLOYD V
Entity Type:Individual
Prefix:
First Name:LLOYD
Middle Name:V
Last Name:BAKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 SHADOWRIDGE DR APT 218
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-9086
Mailing Address - Country:US
Mailing Address - Phone:619-818-0345
Mailing Address - Fax:
Practice Address - Street 1:2260 WATSON WAY
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-7924
Practice Address - Country:US
Practice Address - Phone:760-599-1892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)