Healthcare Provider Details

I. General information

NPI: 1982546255
Provider Name (Legal Business Name): LIFE BALANCE HEALTH PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 POOLE BLVD STE 208
YUBA CITY CA
95993-2666
US

IV. Provider business mailing address

1510 POOLE BLVD STE 208
YUBA CITY CA
95993-2666
US

V. Phone/Fax

Practice location:
  • Phone: 702-551-2516
  • Fax: 702-344-2986
Mailing address:
  • Phone: 702-551-2516
  • Fax: 702-344-2986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: PATRICK OLLAR
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: PMHNP-BC
Phone: 702-551-2516