Provider Demographics
NPI:1568226819
Name:BALCACERES, BETSY LELANY
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:LELANY
Last Name:BALCACERES
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 1:635 W RICE ST
Mailing Address - Street 2:
Mailing Address - City:BLYTHE
Mailing Address - State:CA
Mailing Address - Zip Code:92225-2528
Mailing Address - Country:US
Mailing Address - Phone:818-447-5464
Mailing Address - Fax:
Practice Address - Street 1:635 W RICE ST
Practice Address - Street 2:
Practice Address - City:BLYTHE
Practice Address - State:CA
Practice Address - Zip Code:92225-2528
Practice Address - Country:US
Practice Address - Phone:818-447-5464
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
Yes172V00000XOther Service ProvidersCommunity Health Worker