Provider Demographics
NPI:1710852967
Name:BAKER, KIMBERLY NOHEMY (RN)
Entity type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:NOHEMY
Last Name:BAKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7252 ARCHIBALD AVE.
Mailing Address - Street 2:PO BOX #146
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739
Mailing Address - Country:US
Mailing Address - Phone:909-204-1548
Mailing Address - Fax:
Practice Address - Street 1:7252 ARCHIBALD AVE.
Practice Address - Street 2:PO BOX #146
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91739
Practice Address - Country:US
Practice Address - Phone:909-204-1548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95236076163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy