person
Lisa Ballantyne
Psychiatric/Mental Health Registered Nurse in Santa Rosa, California
NPI 1730646746

Lisa Ballantyne is a Psychiatric/Mental Health Registered Nurse based in Santa Rosa, CA and is specialized in Psychiatric/Mental Health. Lisa Ballantyne practices in Santa Rosa, CA. The NPI Number for Lisa Ballantyne is 1730646746 and holds a License No. 612777 (California).

The current practice location address for Lisa Ballantyne is 2245 Challenger Way, Santa Rosa, CA and can be reached out via phone at 707-565-4970.

Location: 2245 Challenger Way, Santa Rosa, CA, 95407-5418
person
Provider Profile Details
NPI Number
1730646746
Provider Name
Lisa Ballantyne
Credential
Provider Entity Type
Individual
Gender
Female
Address
2245 Challenger Way, Santa Rosa, CA, 95407-5418
Phone Number
707-565-4970
Fax Number
Provider Enumeration Date
02/26/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
612777 01 CA MEDI-CAL
institution
Provider Business Practice Location Address Details
Address
2245 Challenger Way
City
State
Zip
95407-5418
Phone Number
707-565-4970
Fax Number
person
Provider Business Mailing Address Details
Address
2245 Challenger Way
City
State
Zip
95407-5418
Phone Number
707-565-4970
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
612777 (California)
Definition
Definition to come...
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