Individual provider Active NPI

Devon Shane Baker

  • Mental Health Counselor
  • San Mateo, CA
National Provider Identifier
1568239184
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
327 N San Mateo Dr Ste 9
San Mateo, CA 94401-2585
Phone
(650) 549-5009
NPI assigned
Dec 4, 2023
Last updated
Dec 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

327 N San Mateo Dr Ste 9
San Mateo, CA 94401-2585

Mailing address

3130 Alpine Rd Ste 288 PMB 135
Portola Valley, CA 94028-7541
Phone (650) 549-5009

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

NPI Registry JSON

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1568239184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 ALPINE RD STE 288 PMB 135",
            "city": "PORTOLA VALLEY",
            "state": "CA",
            "postal_code": "940287541",
            "telephone_number": "650-549-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 N SAN MATEO DR STE 9",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012585",
            "telephone_number": "650-549-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "DEVON",
        "middle_name": "SHANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "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 Dec 4, 2023; 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.