Provider Demographics
NPI:1871345934
Name:STEAD BAIGRIE, KAREN JOYCE
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:JOYCE
Last Name:STEAD BAIGRIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:
Other - Last Name:BAIGRIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:981 BUTTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANSELMO
Mailing Address - State:CA
Mailing Address - Zip Code:94960-1147
Mailing Address - Country:US
Mailing Address - Phone:646-872-0564
Mailing Address - Fax:
Practice Address - Street 1:330 N BRAND BLVD STE 700
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-2336
Practice Address - Country:US
Practice Address - Phone:800-516-0975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA-3819930171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach