Provider Demographics
NPI:1215244876
Name:BAUMER, SONJA
Entity type:Individual
Prefix:
First Name:SONJA
Middle Name:
Last Name:BAUMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 FRANKLIN ST STE 312
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-2921
Mailing Address - Country:US
Mailing Address - Phone:858-922-3855
Mailing Address - Fax:510-868-1044
Practice Address - Street 1:1904 FRANKLIN ST STE 312
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-2921
Practice Address - Country:US
Practice Address - Phone:858-922-3855
Practice Address - Fax:510-868-1044
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84141106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist