Provider Demographics
NPI:1487536116
Name:BAKER, ANGELICA MARIE (MS)
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:MARIE
Last Name:BAKER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 HILLTOP DR APT 616
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94806-5788
Mailing Address - Country:US
Mailing Address - Phone:701-818-9613
Mailing Address - Fax:
Practice Address - Street 1:120 N REDWOOD DR STE 3
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-1941
Practice Address - Country:US
Practice Address - Phone:415-473-4274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program