Healthcare Provider Details

I. General information

NPI: 1972418630
Provider Name (Legal Business Name): HANNAH B BALASSA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

432 S MILL ST APT 1
TEHACHAPI CA
93561-2027
US

IV. Provider business mailing address

1411 CIMARRON CT APT 1
TEHACHAPI CA
93561-2444
US

V. Phone/Fax

Practice location:
  • Phone: 661-822-8223
  • Fax: 661-823-9347
Mailing address:
  • Phone: 661-271-7677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: