MEDICARE: LIFE BALANCE HEALTH PROFESSIONAL CORPORATION

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1982546255
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE BALANCE HEALTH PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	1510 POOLE BLVD STE 208
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95993-2666
Country	:	US
Telephone Number	:	702-551-2516
Fax Number	:	702-344-2986

Provider Business Practice Location Address
First Line	:	1510 POOLE BLVD STE 208
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95993-2666
Country	:	US
Telephone Number	:	702-551-2516
Fax Number	:	702-344-2986

Authorized Official
Title or Position	:	PSYCHIATRIC NURSE PRACTITIONER
Name	:	PATRICK OLLAR
Credential	:	PMHNP-BC
Telephone Number	:	702-551-2516

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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