Provider Demographics
NPI:1255122917
Name:BALLARD, JULIET KATHRYNE
Entity type:Individual
Prefix:
First Name:JULIET
Middle Name:KATHRYNE
Last Name:BALLARD
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 1:3288 EL CAJON BLVD STE 1B
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-1430
Mailing Address - Country:US
Mailing Address - Phone:949-342-0088
Mailing Address - Fax:
Practice Address - Street 1:32121 PEPPERTREE BND
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-3943
Practice Address - Country:US
Practice Address - Phone:949-342-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)