Provider Demographics
NPI:1972087039
Name:BAISA, SHEILA (MSW)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:
Last Name:BAISA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1039 N LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-1534
Mailing Address - Country:US
Mailing Address - Phone:818-399-2349
Mailing Address - Fax:
Practice Address - Street 1:1039 N LINCOLN ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-1534
Practice Address - Country:US
Practice Address - Phone:818-399-2349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2020-04-30
Deactivation Date:2018-11-09
Deactivation Code:
Reactivation Date:2019-12-17
Provider Licenses
StateLicense IDTaxonomies
CA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker