Jacob Ballard

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CI48150725 Issued in CA

Practice address

115 E Fesler St
Santa Maria, CA 93454-4404

Phone

(805) 922-6597

NPI assigned

Jan 25, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jake Ballard Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of Mono

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mammoth Lakes, CA
  • NPI 1538266911
  NPD (past)
• Mono County Behavioral Health

  • Community/Behavioral Health Agency
  • Mammoth Lakes, CA
  • NPI 1861050643
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1053027854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 E FESLER ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934544404",
            "telephone_number": "805-922-6597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E FESLER ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934544404",
            "telephone_number": "805-922-6597"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "590 Rio Lindo Ave",
            "address_purpose": "LOCATION",
            "city": "Chico",
            "state": "CA",
            "postal_code": "959261817",
            "country_code": "US",
            "telephone_number": "530-345-3491",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3707 E Shields Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937267029",
            "country_code": "US",
            "telephone_number": "559-229-9040",
            "fax_number": "559-229-9060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-25",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "CI48150725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAKE",
            "last_name": "BALLARD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Isra Bala
• Michelle Ocampo Baladad
• Alhelia Balbuena-Velasquez
• Carolyn R Baldiviez, D.D.S.
• Zipporah Balete, OD
• Federico Banales, MD
• Rocio Bandera de Willard
• Julian Bandura, DO
• Riana Banks, IMF 68538
• Ana Barajas Ventura

• Addiction (Substance Use Disorder) Counselor in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.