Corey Thomas Baker
Individual provider Active NPI Licensed Psychiatric Technician · Atascadero, CA
NPI 1164067229 · NPPES record last updated Nov 13, 2019
Key facts
- NPI
- 1164067229
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Psychiatric Technician 167G00000X
- License
- 41105 (CA)
- Practice address
- 5205 Cascabel Rd
Atascadero, CA 93422-2316 - Phone
- (805) 439-4890
- NPI assigned
- Nov 13, 2019
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41105 | CA | MD | Licensed Psychiatric Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Psychiatric Technician | 167G00000X | 41105 | CA | Yes |
Addresses
Primary practice location
5205 Cascabel Rd
Atascadero, CA 93422-2316
Mailing address
2945 McMillan Ave Ste 240
San Luis Obispo, CA 93401-6771
Other providers in Atascadero, CA
- B. Madzarevic, D.D.S., Inc.
- Camille Babida
- Babujyan Healthcare Hospice, Inc.
- Daniela Bagan
- Shelley Theresa Bailey
- Eden-Rose Feuermann Baker
- Linda Joan Baker
- Erika Jasmine Banderas
- Suresh Chandra Bangara
- Jayne Elizabeth Barber
All providers in Atascadero, CA · Licensed Psychiatric Technician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.