Sandra Balderas Perez

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

115548 Issued in CA

Practice address

1130 12TH St Ste C
Modesto, CA 95354-0834

Phone

(209) 525-5373

NPI assigned

Mar 6, 2013

Last updated

Apr 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1164763769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 579243",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953579243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 12TH ST STE C",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953540834",
            "telephone_number": "209-525-5373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDERAS PEREZ",
        "first_name": "SANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-06",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "115548",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "115548",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roohi Shahjahan Bakhath, MD
• Terrilyn Marie Balaam
• Naoum A Baladi, M.D.
• Ashwin Aravinthan Balaguru
• Brittney Balaoing
• Lorraine Lena Baldi
• Leanne Baldwin, IMF
• Surendra Prasad Balgobind, D.D.S
• Michael Cameron Baliel
• Hanat Nambi Balimuttajjo

• Marriage & Family Therapist in Modesto, CA
• Providers in Modesto, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.