Provider Demographics
NPI:1588981021
Name:BAKER, DOUGLAS J (MFT)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:J
Last Name:BAKER
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2911 ADAMS AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-1509
Mailing Address - Country:US
Mailing Address - Phone:619-261-9269
Mailing Address - Fax:858-408-4485
Practice Address - Street 1:2911 ADAMS AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92116-1509
Practice Address - Country:US
Practice Address - Phone:619-261-9269
Practice Address - Fax:858-408-4485
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health