Provider Demographics
NPI:1417095001
Name:BAUMGARTEN, FRANCES (PHD)
Entity Type:Individual
Prefix:DR
First Name:FRANCES
Middle Name:
Last Name:BAUMGARTEN
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 1:3419 VIA LIDO
Mailing Address - Street 2:#353
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3908
Mailing Address - Country:US
Mailing Address - Phone:949-474-8442
Mailing Address - Fax:949-650-6664
Practice Address - Street 1:1000 QUAIL ST
Practice Address - Street 2:SUITE 187
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2731
Practice Address - Country:US
Practice Address - Phone:949-474-8442
Practice Address - Fax:949-650-6664
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9221103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP9221Medicare ID - Type UnspecifiedPSYCHOLOGIST