Provider Demographics
NPI:1578756714
Name:BAKER, JAMES K (MFT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:K
Last Name:BAKER
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4283 PIEDMONT AVE STE A-6
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-4758
Mailing Address - Country:US
Mailing Address - Phone:510-788-0006
Mailing Address - Fax:
Practice Address - Street 1:4283 PIEDMONT AVE STE A-6
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-4758
Practice Address - Country:US
Practice Address - Phone:510-788-0006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49463106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist