Active NPI
Mia Balakushna
- Social Worker
- Fairfield, CA
National Provider Identifier
1598048829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 73543
- Practice address
- 744 Empire St Ste 160
Fairfield, CA 94533-5562 - Phone
- (925) 768-9296
- NPI assigned
- Sep 22, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 73543 | CA | Primary |
Addresses
Primary practice location
744 Empire St Ste 160
Fairfield, CA 94533-5562
Mailing address
744 Empire St Ste 160
Fairfield, CA 94533-5562
Phone (259) 768-9296
Other names 1
- Mia Hogains
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620604800000",
"number": "1598048829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "744 EMPIRE ST STE 160",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945335562",
"telephone_number": "259-768-9296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "744 EMPIRE ST STE 160",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945335562",
"telephone_number": "925-768-9296"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALAKUSHNA",
"first_name": "MIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-22",
"last_updated": "2021-05-10",
"certification_date": "2021-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "73543",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MIA",
"last_name": "HOGAINS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.