Provider Demographics
NPI:1992030829
Name:BAKER, ELIZABETH ANN (MFT)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:BAKER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4500 E PACIFIC COAST HWY
Mailing Address - Street 2:#120
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-3275
Mailing Address - Country:US
Mailing Address - Phone:562-597-7575
Mailing Address - Fax:562-498-8309
Practice Address - Street 1:4500 E PACIFIC COAST HWY
Practice Address - Street 2:#120
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-3275
Practice Address - Country:US
Practice Address - Phone:562-597-7575
Practice Address - Fax:562-498-8309
Is Sole Proprietor?:No
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC40216106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist