Suzanne Ballen
Individual provider Active NPI Clinical Social Worker · San Andreas, CA
NPI 1336716828 · NPPES record last updated Jul 9, 2024
Key facts
- NPI
- 1336716828
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- ASW113780 (CA)
- Practice address
- 891 Mountain Ranch Rd
San Andreas, CA 95249-9713 - Phone
- (209) 754-6525
- NPI assigned
- Jun 4, 2021
- Sex
- Female
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW113780 | CA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ASW113780 | CA | Yes |
Addresses
Primary practice location
891 Mountain Ranch Rd
San Andreas, CA 95249-9713
Mailing address
891 Mountain Ranch Rd
San Andreas, CA 95249-9713
Phone (209) 419-5495
Other providers in San Andreas, CA
- Monna Armstrong
- Sharon S Armstrong
- Pardeep Athwal
- Avalon Care Center-San Andreas LLC
- Wylie James Bagley
- Dennis Baluyut
- Maria S Barajas
- Berenice Barrios
- Haley Barth
- Marian Bell
All providers in San Andreas, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.