Thomas Byron Ballard Jr., PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY11676 Issued in CA

Practice address

26891 Spring St
San Juan Capistrano, CA 92675-2692

Phone

(949) 361-7891

Fax

(949) 361-7895

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497837314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26891 SPRING ST",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926752692",
            "telephone_number": "949-361-7891",
            "fax_number": "949-361-7895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26891 SPRING ST",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926752692",
            "telephone_number": "949-361-7891",
            "fax_number": "949-361-7895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "THOMAS",
        "middle_name": "BYRON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY11676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha A. Bahnam
• Brynn Christin Bailey, MS, PA-C
• Kelsey Haunani Bains, ATC, CPM, LM
• Carolynn Marie Baker, MA, BCBA
• Juliet Kathryne Ballard
• Lisa Bancroft, BCBA
• Bandera Healthcare LLC
• Grace Barkema, AMFT
• Annamarie Helen Barsoe, MFT
• Paul Gregory Batchelor

• Clinical Psychologist in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.