Individual provider Active NPI

Paulette Arreola Balasan, NP

  • Nurse Practitioner
  • Sylmar, CA
National Provider Identifier
1396933255
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP17726 Issued in CA
Practice address
14445 Olive View Drive
Sylmar, CA 91342
Phone
(818) 364-3031
NPI assigned
Oct 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP17726 CA Primary

Addresses

Primary practice location

14445 Olive View Drive
Sylmar, CA 91342

Mailing address

4207 East Jacinto Way
Long Beach, CA 90815
Phone (310) 400-2280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150720000613 CA Practitioner - Nurse Practitioner 4688813108 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP17726CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince May 25, 2015 Accepting new patients
County of Los Angeles CurrentSince May 25, 2015 Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

1000 W Carson St
Torrance, CA 90502
Phone (310) 222-3501

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191456000000",
    "number": "1396933255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 EAST JACINTO WAY",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90815",
            "telephone_number": "310-400-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DRIVE",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "91342",
            "telephone_number": "818-364-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALASAN",
        "first_name": "PAULETTE",
        "middle_name": "ARREOLA",
        "name_prefix": "Dr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-04",
        "last_updated": "2007-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP17726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

Verify at the official NPI Registry.