Healthcare Provider Details

I. General information

NPI: 1164336202
Provider Name (Legal Business Name): CESAR BALDERAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 6TH ST
LINCOLN CA
95648-1825
US

IV. Provider business mailing address

600 6TH ST
LINCOLN CA
95648-1825
US

V. Phone/Fax

Practice location:
  • Phone: 916-645-6350
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: