Healthcare Provider Details

I. General information

NPI: 1710805064
Provider Name (Legal Business Name): DANIELTROY FRANK BALDERAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8391 AUBURN BLVD
CITRUS HEIGHTS CA
95610-0364
US

IV. Provider business mailing address

5300 ANGELES VISTA BLVD
VIEW PARK CA
90043-1648
US

V. Phone/Fax

Practice location:
  • Phone: 916-923-5444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: