Provider Demographics
NPI:1942797873
Name:BALANCED HEALTH AND WELLNESS, A NURSING CORPORATION
Entity Type:Organization
Organization Name:BALANCED HEALTH AND WELLNESS, A NURSING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARNED
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:949-606-4698
Mailing Address - Street 1:8 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LADERA RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92694-0563
Mailing Address - Country:US
Mailing Address - Phone:949-874-2067
Mailing Address - Fax:
Practice Address - Street 1:26400 LA ALAMEDA STE 208
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6307
Practice Address - Country:US
Practice Address - Phone:949-606-4698
Practice Address - Fax:949-215-2529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-17
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherIRS EIN NUMBER