Provider Demographics
NPI:1780708198
Name:BALFOUR, SUMMER DAWN
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:DAWN
Last Name:BALFOUR
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 1:9509 FOULKS RANCH DR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-4321
Mailing Address - Country:US
Mailing Address - Phone:916-609-4914
Mailing Address - Fax:
Practice Address - Street 1:9509 FOULKS RANCH DR
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-4321
Practice Address - Country:US
Practice Address - Phone:916-609-4914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator