Individual
ELLEN J BALIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D.
Contact information
Practice address
2025 LINCOLN ST, BERKELEY, CA 94709-2017
(925) 783-3640
Mailing address
4208 SPAULDING ST, ANTIOCH, CA 94531-8220
(925) 783-3640
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY 18031
CA
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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