Provider Demographics
NPI:1790913515
Name:BALGOOYEN, LUCINDA JEAN (CHT)
Entity Type:Individual
Prefix:MS
First Name:LUCINDA
Middle Name:JEAN
Last Name:BALGOOYEN
Suffix:
Gender:F
Credentials:CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:852 MANZANITA CT
Mailing Address - Street 2:SUITE 145
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2399
Mailing Address - Country:US
Mailing Address - Phone:530-892-1196
Mailing Address - Fax:530-892-1810
Practice Address - Street 1:852 MANZANITA CT
Practice Address - Street 2:SUITE 145
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2399
Practice Address - Country:US
Practice Address - Phone:530-892-1196
Practice Address - Fax:530-892-1810
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHT509-218174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist