Healthcare Provider Details

I. General information

NPI: 1013426352
Provider Name (Legal Business Name): CARLEE Y BALZARETTI FNP-BC, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARLEE Y STEWART

II. Dates (important events)

Enumeration Date: 09/28/2017
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CONCORD AVE STE 450
CONCORD CA
94520-4959
US

IV. Provider business mailing address

2130 FULTON ST
SAN FRANCISCO CA
94117-1080
US

V. Phone/Fax

Practice location:
  • Phone: 925-933-2627
  • Fax:
Mailing address:
  • Phone: 510-409-1913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number681672
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number681672
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95006713
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: