Healthcare Provider Details

I. General information

NPI: 1922069335
Provider Name (Legal Business Name): LESLIE JEANNE BALLARD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 ANTELOPE BLVD SUITE 24
RED BLUFF CA
96080-2465
US

IV. Provider business mailing address

50 OAK DR
CHICO CA
95926-1807
US

V. Phone/Fax

Practice location:
  • Phone: 530-528-7650
  • Fax: 530-528-7655
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number234527
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberC52573
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: