Provider Demographics
NPI:1568652139
Name:BAKER, GAIL (LMFT)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39905 BIRD LN APT 16
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-5104
Mailing Address - Country:US
Mailing Address - Phone:760-770-0906
Mailing Address - Fax:
Practice Address - Street 1:45445 PORTOLA AVE STE 1
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-4844
Practice Address - Country:US
Practice Address - Phone:760-385-3959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF46855101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health