Healthcare Provider Details

I. General information

NPI: 1861077372
Provider Name (Legal Business Name): JUDY ANN ARELLANO BALLESTEROS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2021
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 CECIL AVE
DELANO CA
93215-1424
US

IV. Provider business mailing address

2221 CORTEZ WAY
DELANO CA
93215-4993
US

V. Phone/Fax

Practice location:
  • Phone: 626-406-1444
  • Fax:
Mailing address:
  • Phone: 661-458-6671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-23-68406
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: