Provider Demographics
NPI:1578843959
Name:BAITIS, SARAH PATRICIA (MSMFT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:PATRICIA
Last Name:BAITIS
Suffix:
Gender:F
Credentials:MSMFT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:PATRICIA
Other - Last Name:BALDWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:530 S LAKE AVE
Mailing Address - Street 2:#135
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-3515
Mailing Address - Country:US
Mailing Address - Phone:626-421-4595
Mailing Address - Fax:
Practice Address - Street 1:15317 RAYEN ST
Practice Address - Street 2:
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-5117
Practice Address - Country:US
Practice Address - Phone:818-892-4323
Practice Address - Fax:818-893-4509
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA#95-2633765OtherMEDI-CAL