Healthcare Provider Details

I. General information

NPI: 1265261366
Provider Name (Legal Business Name): KRISTIN CLAIRE BALL AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8421 AUBURN BLVD STE 3
CITRUS HEIGHTS CA
95610-0391
US

IV. Provider business mailing address

8421 AUBURN BLVD STE 3
CITRUS HEIGHTS CA
95610-0391
US

V. Phone/Fax

Practice location:
  • Phone: 916-512-8420
  • Fax:
Mailing address:
  • Phone: 916-512-8420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number158208
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: