Provider Demographics
NPI:1386823532
Name:BALLOT, JULIA K
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:K
Last Name:BALLOT
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 1:2125 KNOLL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7329
Mailing Address - Country:US
Mailing Address - Phone:805-654-7601
Mailing Address - Fax:805-654-7667
Practice Address - Street 1:2125 KNOLL DR STE 200
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-7329
Practice Address - Country:US
Practice Address - Phone:805-654-7601
Practice Address - Fax:805-654-7667
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA566432171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator