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General NPI Number Information
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NPI Number | 1427709740
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Entity Type | Individual
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Provider Name | PETER BALVUENA ACSW
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Gender | Male
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Dates
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Enumeration Date | 01/18/2022
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 4211 AVALON BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90011-5622
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Country | US
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Telephone | 323-233-0425
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Fax |
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Provider Business Mailing Address
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Address Line | 8732 IVY ST
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City | LOS ANGELES
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State | CA
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Zip | 90002-1536
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Country | US
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Telephone | 323-579-5254
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 134305
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License Number State | CA
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