Debra Lee Balke, MD

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

G78900 Issued in CA

Practice address

1320 Las Tablas Rd
Suite E
Templeton, CA 93465-9711

Phone

(805) 434-0960

Fax

(805) 434-0978

NPI assigned

Oct 24, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 Medicine

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508940081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 LAS TABLAS RD",
            "address_2": "SUITE E",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934659711",
            "telephone_number": "805-434-0960",
            "fax_number": "805-434-0978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 LAS TABLAS RD",
            "address_2": "SUITE E",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934659711",
            "telephone_number": "805-434-0960",
            "fax_number": "805-434-0978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALKE",
        "first_name": "DEBRA",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "CA",
            "license": "G78900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neurology with Special Qualifications in Child Neurology Physician in Templeton, CA
• Providers in Templeton, CA by specialty
• Neurology with Special Qualifications in Child Neurology Physician 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.