Provider Demographics
NPI:1861628232
Name:BAKER, KAREN MONIQUE (MA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MONIQUE
Last Name:BAKER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8421 AUBURN BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-0391
Mailing Address - Country:US
Mailing Address - Phone:916-722-6100
Mailing Address - Fax:916-722-9229
Practice Address - Street 1:8421 AUBURN BLVD STE 3
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-0391
Practice Address - Country:US
Practice Address - Phone:916-722-6100
Practice Address - Fax:916-722-9229
Is Sole Proprietor?:No
Enumeration Date:2009-05-29
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT90144106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist