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NPI Code Detail

MEDICARE: KIMBER L BALLOW APCC

MEDICARE: KIMBER L BALLOW APCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor17755CA

General Provider Information

NPI Number : 1356171607
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBER L BALLOW APCC
Provider Business Mailing Address
First Line : 3002 ARMSTRONG ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-5702
Country : US
Telephone Number : 858-633-4100
Fax Number :
Provider Business Practice Location Address
First Line : 3002 ARMSTRONG ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-5702
Country : US
Telephone Number : 858-633-4100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2024
Last Update Date : 01/23/2026

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Directions to “ KIMBER L BALLOW APCC” Practice Location

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