Provider Demographics
NPI:1720377559
Name:SINGH, BABA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BABA
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6577
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91003-6577
Mailing Address - Country:US
Mailing Address - Phone:626-644-7930
Mailing Address - Fax:626-765-9647
Practice Address - Street 1:9985 SIERRA AVE
Practice Address - Street 2:MOB 2-6TH FLR
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-6720
Practice Address - Country:US
Practice Address - Phone:626-644-7930
Practice Address - Fax:626-765-9647
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-01
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY25299103TH0004X, 103TR0400X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation