Provider Demographics
NPI:1275083545
Name:BALUYOT, PEACHY (RN)
Entity Type:Individual
Prefix:
First Name:PEACHY
Middle Name:
Last Name:BALUYOT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 CHERRY BLOSSOM CT UNIT 201
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91915-2932
Mailing Address - Country:US
Mailing Address - Phone:718-840-8305
Mailing Address - Fax:
Practice Address - Street 1:2151 CHERRY BLOSSOM CT UNIT 201
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91915-2932
Practice Address - Country:US
Practice Address - Phone:718-840-8305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-10
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22665988163W00000X
CA95179645163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse