Individual
ELISHA DANIEL BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4740 VON KARMAN AVE, NEWPORT BEACH, CA 92660-8109
(949) 910-3197
Mailing address
662 HAYES, IRVINE, CA 92620-3755
(253) 222-8490
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
08/03/2023
Last updated
08/03/2023
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