1942703459 NPI number — DEBORAH IRENE SINNETTE-BAIRD LPCC

Table of content: DEBORAH IRENE SINNETTE-BAIRD LPCC (NPI 1942703459)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942703459 NPI number — DEBORAH IRENE SINNETTE-BAIRD LPCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SINNETTE-BAIRD
Provider First Name:
DEBORAH
Provider Middle Name:
IRENE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SINNETTE-BAIRD
Provider Other First Name:
DEBBY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1942703459
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/09/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
07/30/2019
NPI Reactivation Date:
08/09/2019

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
250 MADELINE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONROVIA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91016-2432
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-708-0049
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
482 N ROSEMEAD BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PASADENA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91107-3000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-708-0049
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/11/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  67 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 67 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)