Stacie A Baum

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

145931 Issued in CA

Practice address

4545 N West Ave
Fresno, CA 93705

Phone

(559) 229-3561

NPI assigned

Jun 12, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Mrs. Stacie A Atkinson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Comprehensive Youth Services of Fresno, Inc.

  • Community/Behavioral Health Agency
  • Fresno, CA
  • NPI 1730213323
  NPD (past)
• Comprehensive Youth Services of Fresno, Inc. (Functional Family Therap

  • Community/Behavioral Health Agency
  • Fresno, CA
  • NPI 1437328044
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1023370350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 N WEST AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937050946",
            "telephone_number": "559-229-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 N WEST AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93705",
            "telephone_number": "559-229-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUM",
        "first_name": "STACIE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-12",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT106217",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF67387",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "145931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACIE",
            "last_name": "ATKINSON",
            "middle_name": "A",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Christopher William Bauer, DMD
• Leah Bauer, MD, MPH
• Michal Tennen Bauer, DO
• Stephanie Jane Bauer
• Aquina Lajewel Baulkman
• Sandra L Bausman, PT, WCS
• Bautista Medical Group (Bautista Research Medical Clinic)
• Bautista Medical Group Inc
• Francisca Bautista Salazar
• Amylene Bautista

• Marriage & Family Therapist in Fresno, CA
• Providers in Fresno, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.