Provider Demographics
NPI:1588933253
Name:BETH BAUMEISTER, PH.D.
Entity type:Organization
Organization Name:BETH BAUMEISTER, PH.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:BAUMEISTER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:626-221-6187
Mailing Address - Street 1:2239 TOWNSGATE RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2405
Mailing Address - Country:US
Mailing Address - Phone:626-221-6187
Mailing Address - Fax:626-221-6187
Practice Address - Street 1:1546 CALLE HONDANADA
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-6825
Practice Address - Country:US
Practice Address - Phone:626-221-6187
Practice Address - Fax:626-221-6187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20565103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty