Jashan Ballagan

Individual provider Active NPI Peer Specialist · Livermore, CA

NPI 1124893409 · NPPES record last updated Nov 16, 2023

Key facts

NPI
1124893409
Entity type
Individual (NPI type 1)
Primary specialty
Peer Specialist 175T00000X
Practice address
3311 Pacific Ave
Livermore, CA 94550-7007
Phone
(925) 462-1755
NPI assigned
Nov 16, 2023
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Yes

Addresses

Primary practice location

3311 Pacific Ave
Livermore, CA 94550-7007

Mailing address

2801 Rabbit Hollow Dr
Lathrop, CA 95330-9841
Phone (209) 637-6046

Other providers in Livermore, CA

All providers in Livermore, CA · Peer Specialist in California

Sources for this page

Verify at the official NPI Registry.