MEDICARE: MR. MATTHEW BALAND

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
1	106H00000X	Marriage & Family Therapist	49232	CA

General Provider Information

NPI Number	:	1871601609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MATTHEW BALAND

Provider Business Mailing Address
First Line	:	6147 SUTTER AVE
Second Line	:
City	:	CARMICHAEL
State	:	CA
Zip	:	95608-2738
Country	:	US
Telephone Number	:	916-971-5360
Fax Number	:

Provider Business Practice Location Address
First Line	:	6615 VALLEY HI DR
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-7076
Country	:	US
Telephone Number	:	916-450-2650
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	03/26/2021

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Directions to “ MR. MATTHEW BALAND ” Practice Location

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