Healthcare Provider Details

I. General information

NPI: 1437025418
Provider Name (Legal Business Name): KRISTEE BALTZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

338 S DAKOTA AVE
LOMPOC CA
93437-6307
US

IV. Provider business mailing address

693 TILIA ST
SANTA MARIA CA
93455-3228
US

V. Phone/Fax

Practice location:
  • Phone: 805-606-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number95411974
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: