Individual
STEPHAN LEO BALITAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4258 TELEGRAPH RD, VENTURA, CA 93003-3706
(805) 477-5700
Mailing address
4258 TELEGRAPH RD, VENTURA, CA 93003-3706
(805) 477-5700
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95160434
CA
Other
Enumeration date
08/29/2019
Last updated
08/29/2019
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