Provider Demographics
NPI:1215959408
Name:BAYLOR, CHANDRA EUCALYPTUS (MFT, BC-DMT, CEDS)
Entity type:Individual
Prefix:MS
First Name:CHANDRA
Middle Name:EUCALYPTUS
Last Name:BAYLOR
Suffix:
Gender:F
Credentials:MFT, BC-DMT, CEDS
Other - Prefix:
Other - First Name:CHANDRA
Other - Middle Name:EUCALYPTUS
Other - Last Name:CHAIKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LMFT
Mailing Address - Street 1:25401 CABOT RD STE 115
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-5530
Mailing Address - Country:US
Mailing Address - Phone:949-215-0612
Mailing Address - Fax:949-215-0636
Practice Address - Street 1:25401 CABOT RD STE 115
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-5530
Practice Address - Country:US
Practice Address - Phone:949-215-0612
Practice Address - Fax:949-215-0636
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT43942106H00000X
CAMFC43942106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3632960OtherCHANDRA CHAIKIN, MS, LICENSED MARRIAGE FAMILY THERAPY, APC