Healthcare Provider Details
I. General information
NPI: 1265067383
Provider Name (Legal Business Name): KATHRYN ANN BALINA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/09/2020
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1201 W LA VETA AVE
ORANGE CA
92868-4203
US
IV. Provider business mailing address
1201 W LA VETA AVE
ORANGE CA
92868-4203
US
V. Phone/Fax
- Phone: 714-683-0593
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: