Provider Demographics
NPI:1083775209
Name:BAKER, RALPH M (PHD)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:M
Last Name:BAKER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:727 FAIRVIEW DR.
Mailing Address - Street 2:STE A
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-5493
Mailing Address - Country:US
Mailing Address - Phone:775-684-5000
Mailing Address - Fax:775-687-1181
Practice Address - Street 1:215 W, BRIDGE ST.
Practice Address - Street 2:STE 5
Practice Address - City:YERINGTON
Practice Address - State:NV
Practice Address - Zip Code:89447-2544
Practice Address - Country:US
Practice Address - Phone:775-463-3191
Practice Address - Fax:775-463-4641
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2022-01-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NVPY0359103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV31783Medicare PIN