Pena-Baltazar, Lupita

Pena-Baltazar, Lupita is an individual health care provider with primary practice located at 1310 Meridian Dr , Woodburn OR 97071-9668. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Case Manager/Care Coordinator. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Pena-Baltazar, Lupita can be contacted via phone (503) 953-0310.

Contact Information

Primary practice address
1310 Meridian Dr Woodburn OR 97071-9668
Phone: (503) 953-0310
Fax: (503) 386-0439
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1104050947
LBN Legal business name Pena-Baltazar, Lupita
Credentials QMHA
Entity Individual
Sole proprietor 1 No
Enumeration date May 7th, 2009
Last updated Aug 4th, 2022 - about 2 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 1104050947 NPPES
Other L10733 OREGON BOARD OF LICENSED SOCIAL WORKERS

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