Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LCS11233 | CA |
NPI | 1003039363 |
---|---|
Provider Name | Barbara Jean Ballif |
First Address | Sacramento, CA 95841-4103 |
Second Address | Sacramento, CA 95841-4103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 08/07/2007 |