Provider Demographics
NPI:1003466046
Name:HOOD-BALLARD, DIANA LYNN
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:LYNN
Last Name:HOOD-BALLARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2453 B ST
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-6590
Mailing Address - Country:US
Mailing Address - Phone:530-764-1198
Mailing Address - Fax:
Practice Address - Street 1:2453 B ST
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-6590
Practice Address - Country:US
Practice Address - Phone:530-764-1198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-11
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty