Provider Demographics
NPI:1508983321
Name:BATY, ILINIZA MARY (MSW)
Entity Type:Individual
Prefix:
First Name:ILINIZA
Middle Name:MARY
Last Name:BATY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1247 7TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-1642
Mailing Address - Country:US
Mailing Address - Phone:310-804-8269
Mailing Address - Fax:
Practice Address - Street 1:1247 7TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-1642
Practice Address - Country:US
Practice Address - Phone:310-804-8269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS205801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical