Individual
MRS. CANDICE MERYL BALLEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
15305 RAYEN ST, NORTH HILLS, CA 91343-5117
(818) 892-3384
(818) 895-5186
Mailing address
15305 RAYEN ST, NORTH HILLS, CA 91343-5117
(818) 892-3384
(818) 895-5186
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-2633765
MEDI-CAL
CA
Enumeration date
07/11/2011
Last updated
05/30/2013
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