Provider Demographics
NPI:1255826269
Name:BAKER, HOLDEN (HA)
Entity Type:Individual
Prefix:
First Name:HOLDEN
Middle Name:
Last Name:BAKER
Suffix:
Gender:M
Credentials:HA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 W CENTRAL AVE STE A
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-3000
Mailing Address - Country:US
Mailing Address - Phone:714-255-8395
Mailing Address - Fax:714-535-4086
Practice Address - Street 1:385 W CENTRAL AVE STE A
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-3000
Practice Address - Country:US
Practice Address - Phone:714-255-8395
Practice Address - Fax:714-535-4086
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA8346237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist