1174141550 NPI number — MRS. ALINE MARIE BALES DNP, PMHNP-BC

Table of content: MRS. ALINE MARIE BALES DNP, PMHNP-BC (NPI 1174141550)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174141550 NPI number — MRS. ALINE MARIE BALES DNP, PMHNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BALES
Provider First Name:
ALINE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DNP, PMHNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174141550
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/15/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
02/03/2025
NPI Reactivation Date:
02/07/2025

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
720 CHICHESTER CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAKERSFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93314-4356
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
925-665-9851
Provider Business Mailing Address Fax Number:
661-365-0163

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
720 CHICHESTER CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93314-4356
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-665-9851
Provider Business Practice Location Address Fax Number:
661-365-0163
Provider Enumeration Date:
07/11/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , with the licence number:  12621 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: 1105558 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: 0024187763 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: AP61444635 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: F405235-01 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: APRN11027497 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: 95025552 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)