Provider Demographics
NPI:1558436501
Name:BALINTH, NOEMI BEATRIX (PHD)
Entity Type:Individual
Prefix:
First Name:NOEMI
Middle Name:BEATRIX
Last Name:BALINTH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2423 CAMINITO OCEAN COVE
Mailing Address - Street 2:CARDIFF-BY-THE-SEA
Mailing Address - City:CARDIFF-BY-THE-SEA
Mailing Address - State:CA
Mailing Address - Zip Code:92007-2226
Mailing Address - Country:US
Mailing Address - Phone:760-944-8300
Mailing Address - Fax:
Practice Address - Street 1:836 PROSPECT STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4213
Practice Address - Country:US
Practice Address - Phone:858-456-2668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 18367103TC0700X
NY010948103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP18367Medicare ID - Type Unspecified