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General NPI Number Information
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NPI Number | 1467636803
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Entity Type | Individual
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Provider Name | CLAUDINE BALICKI LMFT
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Gender | Female
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Dates
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Enumeration Date | 12/20/2007
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 555 UNIVERSITY AVE STE 235
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City | SACRAMENTO
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State | CA
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Zip | 95825-6505
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Country | US
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Telephone | 916-995-4779
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 160311
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City | SACRAMENTO
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State | CA
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Zip | 95816-0311
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Country | US
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Telephone | 916-995-4779
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT 44137
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License Number State | CA
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