Provider Demographics
NPI:1376663146
Name:BALAAM, MAUREEN F (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:F
Last Name:BALAAM
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 CASS ST
Mailing Address - Street 2:SUITE D-6
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4515
Mailing Address - Country:US
Mailing Address - Phone:831-655-3665
Mailing Address - Fax:831-375-1559
Practice Address - Street 1:1010 CASS ST
Practice Address - Street 2:SUITE D-6
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4515
Practice Address - Country:US
Practice Address - Phone:831-655-3665
Practice Address - Fax:831-375-1559
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC23828106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFC23828OtherMARRIAGE FAMILY THERAPIST