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NPI Code Detail

MEDICARE: ANNEMARIE BALLINGER

MEDICARE: ANNEMARIE BALLINGER
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
1106H00000XMarriage & Family TherapistMFC33769CA

General Provider Information

NPI Number : 1881804367
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNEMARIE BALLINGER
Provider Business Mailing Address
First Line : 3103 BIRDSALL AVE.
Second Line :
City : OAKLAND
State : CA
Zip : 94619
Country : US
Telephone Number : 510-713-8437
Fax Number : 510-536-6334
Provider Business Practice Location Address
First Line : 38970 BLACOW RD
Second Line : SUITE C
City : FREMONT
State : CA
Zip : 94536-7380
Country : US
Telephone Number : 510-713-8437
Fax Number : 510-536-6334
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2007
Last Update Date : 07/09/2007

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Directions to “ ANNEMARIE BALLINGER ” Practice Location

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