Provider Demographics
NPI:1447316534
Name:BAKER, JANET KAY (PHD)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:KAY
Last Name:BAKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 GRANITE ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-2716
Mailing Address - Country:US
Mailing Address - Phone:541-552-0760
Mailing Address - Fax:541-482-6093
Practice Address - Street 1:208 OAK ST
Practice Address - Street 2:SUITE 304
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1871
Practice Address - Country:US
Practice Address - Phone:541-552-0760
Practice Address - Fax:541-482-6093
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1324103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR104759Medicare ID - Type Unspecified