Ballantyne, Lisa

Ballantyne, Lisa is an individual health care provider with primary practice located at 2245 Challenger Way , Santa Rosa CA 95407-5418. She recently has only one registered license in Nursing Service Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Ballantyne, Lisa can be contacted via phone (707) 565-4970.

Contact Information

Primary practice address
2245 Challenger Way Santa Rosa CA 95407-5418
Phone: (707) 565-4970
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Psychiatric/Mental Health 163WP0808X 612777 California

Profile Details

NPI number 1730646746
LBN Legal business name Ballantyne, Lisa
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 26th, 2019
Last updated Feb 26th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730646746 NPPES
California Other 612777 MEDI-CAL

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