Individual
DHEZIREE MAY BALEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHN
Contact information
Practice address
3995 ELWOOD CT, CONCORD, CA 94519-1204
(925) 395-3237
Mailing address
3995 ELWOOD CT, CONCORD, CA 94519-1204
(925) 395-3237
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
764898
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F2101981
DRIVER'S LICENSE
CA
Enumeration date
01/25/2017
Last updated
01/25/2017
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