Healthcare Provider Details

I. General information

NPI: 1235064502
Provider Name (Legal Business Name): ALBERTO BALBACAL JR. RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 SNEATH LN STE 300
SAN BRUNO CA
94066-2349
US

IV. Provider business mailing address

400 STATION PARK CIR UNIT 129
SAN MATEO CA
94402-2761
US

V. Phone/Fax

Practice location:
  • Phone: 650-615-6031
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: