Provider Demographics
NPI:1316512924
Name:BAKER, CINDY EDWARDS (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:EDWARDS
Last Name:BAKER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1461 12TH ST APT A
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-6196
Mailing Address - Country:US
Mailing Address - Phone:703-638-3008
Mailing Address - Fax:
Practice Address - Street 1:1461 12TH ST APT A
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-6196
Practice Address - Country:US
Practice Address - Phone:703-638-3008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21979235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist