Provider Demographics
NPI:1962529776
Name:BAKER, RACHEL FENNING (PHD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:FENNING
Last Name:BAKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:RACHEL
Other - Middle Name:MAY
Other - Last Name:FENNING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:800 N STATE COLLEGE BLVD
Mailing Address - Street 2:EC 572
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831-3547
Mailing Address - Country:US
Mailing Address - Phone:657-278-7802
Mailing Address - Fax:
Practice Address - Street 1:2500 RED HILL AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5518
Practice Address - Country:US
Practice Address - Phone:949-267-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-25
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25963103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical