Healthcare Provider Details

I. General information

NPI: 1699656611
Provider Name (Legal Business Name): JOSEPH BALAORO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 FRANKLIN ST APT 506
SAN FRANCISCO CA
94102-6304
US

IV. Provider business mailing address

880 FRANKLIN ST APT 506
SAN FRANCISCO CA
94102-6304
US

V. Phone/Fax

Practice location:
  • Phone: 628-206-2855
  • Fax: 628-206-3986
Mailing address:
  • Phone: 628-206-2855
  • Fax: 628-206-3986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: