Individual
SASHA BALLEZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
845876
CA
163W00000X
Registered Nurse
RN2284708
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
95001230
CA
Other
Enumeration date
02/20/2014
Last updated
12/31/2020
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