Individual
MISS LUPITA PENA-BALTAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHA
Contact information
Practice address
1310 MERIDIAN DR, WOODBURN, OR 97071-9668
(503) 953-0310
(503) 386-0439
Mailing address
7515 FALCON CREST DR # 200, REDMOND, OR 97756-5014
(541) 904-5216
(541) 527-4347
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
L10733
OR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L10733
OREGON BOARD OF LICENSED SOCIAL WORKERS
—
Enumeration date
05/07/2009
Last updated
04/17/2025
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