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General NPI Number Information
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NPI Number | 1114872728
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Entity Type | Individual
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Provider Name | NERISSA BALZARY
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Gender | Female
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Dates
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Enumeration Date | 02/27/2026
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 17815 DAVES AVE
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City | MONTE SERENO
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State | CA
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Zip | 95030-3217
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Country | US
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Telephone | 646-436-1683
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Fax |
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Provider Business Mailing Address
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Address Line | 17815 DAVES AVE
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City | MONTE SERENO
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State | CA
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Zip | 95030-3217
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Country | US
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Telephone | 646-436-1683
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number | US5633475338
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License Number State | CA
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