Jorge Ballesteros, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

34652 Issued in CA

Practice address

21781 Ventura Blvd
Woodland Hills, CA 91364-1835

Phone

(818) 270-8354

NPI assigned

May 16, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1194574699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21781 VENTURA BLVD",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641835",
            "telephone_number": "818-270-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21781 VENTURA BLVD",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641835",
            "telephone_number": "818-270-8354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLESTEROS",
        "first_name": "JORGE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "34652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Braylen Ball
• Jordan Ball
• David Ballam
• Ashley Ann Ballard
• Anthony Ballesteros
• Christine Ballou
• Mona D. Balogh, MD
• Kayla Baltimore
• Ashley Danise Baltodano
• Byung Hoon Ban, D.O.

• Clinical Psychologist in Woodland Hills, CA
• Providers in Woodland Hills, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.