Provider Demographics
NPI:1689086076
Name:BAKER, CHERYL K (CCE, CD, CLE)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:K
Last Name:BAKER
Suffix:
Gender:F
Credentials:CCE, CD, CLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 OCEAN PARK BLVD.
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405
Mailing Address - Country:US
Mailing Address - Phone:310-837-5686
Mailing Address - Fax:
Practice Address - Street 1:1750 OCEAN PARK BLVD.
Practice Address - Street 2:SUITE 206
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405
Practice Address - Country:US
Practice Address - Phone:310-837-5686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No172V00000XOther Service ProvidersCommunity Health Worker