Active NPI
Nancy Lynn Baker, PH.D., ABPP
- Forensic Psychologist
- San Mateo, CA
National Provider Identifier
1093914913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- License
- PSY11673
- Practice address
- 1611 Borel PL
#211
San Mateo, CA 94402-3500 - Phone
- (650) 712-9767
- NPI assigned
- Jul 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Development & Aging Psychologist | 103TA0700X | PSY11673 | CA | |
| Forensic Psychologist | 103TF0200X | PSY11673 | CA | Primary |
Addresses
Primary practice location
1611 Borel PL
#211
San Mateo, CA 94402-3500
Mailing address
1611 Borel PL
#211
San Mateo, CA 94402-3500
Phone (650) 712-9767
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY11673 | CA | MD | Adult Development & Aging Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184112000000",
"number": "1093914913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1611 BOREL PL",
"address_2": "#211",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944023500",
"telephone_number": "650-712-9767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 BOREL PL",
"address_2": "#211",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944023500",
"telephone_number": "650-712-9767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAKER",
"first_name": "NANCY",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PH.D., ABPP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-11",
"last_updated": "2007-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": "CA",
"license": "PSY11673",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "CA",
"license": "PSY11673",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.