Guy Tillman Baxstrum Jr., LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT53065 Issued in CA

Practice address

9540 Center Ave Ste 100
Rancho Cucamonga, CA 91730-5840

Phone

(909) 980-2689

NPI assigned

Aug 17, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428883200000",
    "number": "1972795482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9540 CENTER AVE STE 100",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305840",
            "telephone_number": "909-980-2689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9540 CENTER AVE STE 100",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305840",
            "telephone_number": "909-980-2689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAXSTRUM",
        "first_name": "GUY",
        "middle_name": "TILLMAN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-17",
        "last_updated": "2015-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT53065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BBS",
            "identifier": "LMFT53065",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Estrelita Layugan Baxa, SLP
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• Triyahna Bealer
• Abbie Bean
• Angelica Beas

• Marriage & Family Therapist in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, 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 Apr 13, 2015; 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.