Provider Demographics
NPI:1346259579
Name:BAUM, STEVEN (PSYD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:BAUM
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5665 COLLEGE AVE
Mailing Address - Street 2:STE 330A
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1656
Mailing Address - Country:US
Mailing Address - Phone:510-594-4050
Mailing Address - Fax:
Practice Address - Street 1:5665 COLLEGE AVE
Practice Address - Street 2:STE 330A
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1656
Practice Address - Country:US
Practice Address - Phone:510-287-9024
Practice Address - Fax:510-654-3357
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17497103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP42928Medicare UPIN
CA0PL174970Medicare ID - Type UnspecifiedMEDICARE