Ballou-Harding, Debra

Ballou-Harding, Debra is an sole proprietor health care provider with primary practice located at 14516 Tacuba Dr , La Mirada CA 90638-2043. She recently has 4 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Assisted Living, Mental Illness, Nursing & Custodial Care Facilities / Adult Care Home, Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, Nursing & Custodial Care Facilities / Assisted Living, Behavioral Disturbances. Nursing & Custodial Care Facilities / Assisted Living, Behavioral Disturbances is her primary health care specialty. Ballou-Harding, Debra can be contacted via phone (562) 805-0526.

Contact Information

Primary practice address
14516 Tacuba Dr La Mirada CA 90638-2043
Phone: (562) 805-0526
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living, Mental Illness 3104A0625X
Nursing & Custodial Care Facilities / Adult Care Home 311ZA0620X
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X
Nursing & Custodial Care Facilities / Assisted Living, Behavioral Disturbances 3104A0630X

Profile Details

NPI number 1487314647
LBN Legal business name Ballou-Harding, Debra
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 28th, 2021
Last updated Dec 28th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487314647 NPPES
California MEDICAID 198603544

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