Provider Demographics
NPI:1326802778
Name:BALLON, JUSTINE LAUREN (CD(DONA))
Entity Type:Individual
Prefix:MRS
First Name:JUSTINE
Middle Name:LAUREN
Last Name:BALLON
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 E PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-6827
Mailing Address - Country:US
Mailing Address - Phone:909-367-0879
Mailing Address - Fax:
Practice Address - Street 1:146 E PLEASANT ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-6827
Practice Address - Country:US
Practice Address - Phone:909-367-0879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula