Active NPI
Nathan J Balfanz, PSY.D.
- Psychologist
- San Clemente, CA
National Provider Identifier
1487829008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY26707
- Practice address
- 101 S El Camino Real Ste 201
San Clemente, CA 92672-5503 - Phone
- (949) 880-7997
- NPI assigned
- Apr 24, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | PSY26707 | CA | |
| Psychologist | 103T00000X | PSY26707 | CA | Primary |
Addresses
Primary practice location
101 S El Camino Real Ste 201
San Clemente, CA 92672-5503
Mailing address
609 Calle de Soto
San Clemente, CA 92672-2252
Phone (424) 471-9759
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY26707 | CA | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716163200000",
"number": "1487829008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "609 CALLE DE SOTO",
"city": "SAN CLEMENTE",
"state": "CA",
"postal_code": "926722252",
"telephone_number": "424-471-9759"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 S EL CAMINO REAL STE 201",
"city": "SAN CLEMENTE",
"state": "CA",
"postal_code": "926725503",
"telephone_number": "949-880-7997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALFANZ",
"first_name": "NATHAN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-24",
"last_updated": "2024-05-20",
"certification_date": "2024-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CA",
"license": "PSY26707",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY26707",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Clemente, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.