Provider Demographics
NPI:1821746579
Name:BAER, JEANETTE (PA-C)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:
Last Name:BAER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 ALAMEDA PADRE SERRA
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-2141
Mailing Address - Country:US
Mailing Address - Phone:808-384-2952
Mailing Address - Fax:
Practice Address - Street 1:1805 E CABRILLO BLVD STE C
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93108-2884
Practice Address - Country:US
Practice Address - Phone:805-565-8480
Practice Address - Fax:805-565-8481
Is Sole Proprietor?:No
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA13575363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant