Individual
KEVIN BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1255 KENDALL RD, SAN LUIS OBISPO, CA 93401-8750
(805) 781-3535
Mailing address
2600 SOLANO RD APT B, PISMO BEACH, CA 93449-1752
(805) 440-5126
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
08/05/2022
Last updated
03/20/2025
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