Provider Demographics
NPI:1497079198
Name:BAKER, ALISON J (DPT)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:J
Last Name:BAKER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8121 BUCKTHORN TRAIL
Mailing Address - Street 2:
Mailing Address - City:PINE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91962
Mailing Address - Country:US
Mailing Address - Phone:619-788-9185
Mailing Address - Fax:
Practice Address - Street 1:833 BROADWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-4668
Practice Address - Country:US
Practice Address - Phone:619-447-7774
Practice Address - Fax:619-447-7779
Is Sole Proprietor?:No
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT# 36596225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist