Michelle Lynn Ballard

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

75676 Issued in CA

Practice address

3200 E Guasti Rd Ste 100
Ontario, CA 91761-8661

Phone

(909) 248-4412

NPI assigned

Jan 27, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Stacie Pasimio Ms LMFT

  • Marriage & Family Therapist
  • Ontario, CA
  • NPI 1275193583
  NPD (past)

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

{
    "created_epoch": "1296086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1982900783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7353 ELLENA W",
            "address_2": "UNIT 82",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917308367",
            "telephone_number": "760-946-8200",
            "fax_number": "760-946-8208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 E GUASTI RD STE 100",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917618661",
            "telephone_number": "909-248-4412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7353 ELLENA W",
            "address_2": "UNIT 82",
            "address_purpose": "LOCATION",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917308367",
            "country_code": "US",
            "telephone_number": "760-946-8200 x275",
            "fax_number": "760-946-8208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-27",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "75676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salena Balderrama
• Josiah Baldivia
• Patrick Balisi
• Jenifer Ball
• Mabel Ball
• Erica Ballesteros
• Jacqueline Baltazar
• Yvette Baltazar
• Alexis Baltierra
• Patricia A Banker

• Clinical Social Worker in Ontario, CA
• Providers in Ontario, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.