Healthcare Provider Details

I. General information

NPI: 1144157363
Provider Name (Legal Business Name): PAVEL PETRU BALINT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6408 MENDEZ CREEK CT
ROCKLIN CA
95765-4238
US

IV. Provider business mailing address

6408 MENDEZ CREEK CT
ROCKLIN CA
95765-4238
US

V. Phone/Fax

Practice location:
  • Phone: 916-203-1765
  • Fax: 916-203-1765
Mailing address:
  • Phone: 916-203-1765
  • Fax: 916-203-1765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number312700212
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: