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General NPI Number Information
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NPI Number | 1538642418
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Entity Type | Individual
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Provider Name | MS. MARY GRACE BALBUENA SOSING
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Gender | Female
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Dates
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Enumeration Date | 09/07/2018
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 393 E WALNUT ST REGIONAL BEHAVIORAL HEALTH FL 2
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City | PASADENA
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State | CA
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Zip | 91188-1630
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Country | US
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Telephone | 877-608-0049
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Fax |
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Provider Business Mailing Address
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Address Line | 14071 PEYTON DR UNIT 1845
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City | CHINO HILLS
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State | CA
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Zip | 91709-7180
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Country | US
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Telephone |
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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 | 367199
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License Number State | CA
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