Randi Renae Balderama

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

107023 Issued in CA

Practice address

3451 W Shaw Ave Ste 102
Fresno, CA 93711-3242

Phone

(559) 260-7654

NPI assigned

Aug 4, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1245967827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12388 ROAD 35",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368358",
            "telephone_number": "831-902-8436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 W SHAW AVE STE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113242",
            "telephone_number": "559-260-7654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDERAMA",
        "first_name": "RANDI",
        "middle_name": "RENAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-04",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "107023",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Graciela Balboa
• Radley Aaron Balboa
• Kathryne Balch, BCBA
• Blue Marie Balcita
• Dena Leann Balderama, BA
• Emelyn Balderas
• Hannah Baldis
• Christopher Baldon
• Amy Baldwin
• Charletta Yvonne Baldwin, LVN

• Clinical Social Worker in Fresno, CA
• Providers in Fresno, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.