Individual
JOCKUELA BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2420 MARTIN RD STE 200, FAIRFIELD, CA 94534-8610
(707) 399-4520
Mailing address
2420 MARTIN RD STE 200, FAIRFIELD, CA 94534-8610
(916) 388-6400
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
—
CA
175T00000X
Peer Specialist
—
—
Other
Enumeration date
12/09/2014
Last updated
07/05/2023
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