Individual
CRYSTAL BALLEJOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1481 WINDSOR DR, SAN BERNARDINO, CA 92404-5416
(909) 361-6470
Mailing address
850 E GILBERT ST, SAN BERNARDINO, CA 92415-0001
(909) 387-7200
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
07/14/2015
Last updated
02/04/2019
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