Healthcare Provider Details

I. General information

NPI: 1912819509
Provider Name (Legal Business Name): WILLIAM DAVIS BALBIRNIE CATC I
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 E. 7TH ST
NATIONAL CITY CA
91950
US

IV. Provider business mailing address

24 BEACON WAY
ALISO VIEJO CA
92656-2699
US

V. Phone/Fax

Practice location:
  • Phone: 949-745-0138
  • Fax:
Mailing address:
  • Phone: 949-745-0138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1128831
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: