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General NPI Number Information
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NPI Number | 1699568576
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Entity Type | Individual
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Provider Name | TRINA MONIQUE BALLENTINE ARRT, ARDMS, NTQR
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Gender |
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Dates
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Enumeration Date | 05/23/2025
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 1515 W CAMERON AVE STE 200
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City | WEST COVINA
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State | CA
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Zip | 91790-2734
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Country | US
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Telephone | 626-756-7679
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Fax |
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Provider Business Mailing Address
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Address Line | 62 COUNTRY MILE RD
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City | POMONA
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State | CA
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Zip | 91766-6626
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Country | US
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Telephone | 626-756-7679
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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 | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number | P26015
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number | 1034306
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number | 268943
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License Number State | CA
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