Angela Susan Ballard, LMFT 120205, PCCI is a
Psychologist - Clinical based in San Carlos, California. Angela Susan Ballard is licensed to practice in California (license number LMFT120205) and her current practice location is
1033 Laurel St, San Carlos, California. She can be reached at her office (for appointments etc.) via phone at
(650) 785-2562.
NPI number for Angela Susan Ballard is 1013431899 and her current mailing address is 119 Chester St, Menlo Park, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1013431899.
Healthcare Provider's Profile
| Full Name | Angela Susan Ballard |
|---|
| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 1033 Laurel St, San Carlos, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1013431899
- Provider Enumeration Date: 08/02/2017
- Last Update Date: 07/28/2020
Medical Identifiers
Medical identifiers for Angela Susan Ballard such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1013431899 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | LMFT120205 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Angela Susan Ballard is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Angela Susan Ballard, LMFT 120205, PCCI
119 Chester St,
Menlo Park, CA 94025-2517
Ph: (650) 862-2270 | Angela Susan Ballard, LMFT 120205, PCCI
1033 Laurel St,
San Carlos, CA 94070-3918
Ph: (650) 785-2562 |
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