TANISHA JORDAN BALOGUN


Address: 17270 Roosevelt St # 304, Riverside, CA 92508-9523
Phone: 9517802541

TANISHA JORDAN BALOGUN (NPI# 1750895298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1750895298
Entity Type Individual
Full Name TANISHA JORDAN BALOGUN
Practice Address 17270 Roosevelt St # 304
Riverside
CA 92508-9523
Practice Telephone 9517802541
Mailing Telephone 9517802541
Enumeration Date 2017-11-20
Last Update Date 2017-11-20
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
Behavioral Health & Social Service Providers

Office Location

Street Address 17270 ROOSEVELT ST # 304
City RIVERSIDE
State CA
Zip Code 92508-9523

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1952642399 John Lawrence Bowers Marriage & Family Therapist 19900 Grove Community Drive, Riverside, CA 92508 2013-03-11
1952605248 Dennis Graves Counselor 17270 Roosevelt Ave, Riverside, CA 92508 2011-01-01
1811207632 Bekele T Haimanot Physician Assistant 9528 Los Coches Court, Riverside, CA 92508 2010-10-14
1518144625 Irene T. Zaki Dentist 20873 Grove Community Dr., Riverside, CA 92508 2008-01-31
1093902447 Edward Keith Forward Specialist 18167 Kross Rd, Riverside, CA 92508 2007-10-01
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Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1649884248 Jose G. Cruz Rodriguez Counselor 66 Planet Ave, Riverside, RI 02915-2172 2020-09-02
1124585500 Cesar Quintana Counselor 7177 Brockton Ave Ste 444, Riverside, CA 92506-2635 2019-02-21
1740759067 Kristina Ferris-celosse Counselor 2452 Wilshire St., Riverside, CA 92501 2018-11-15
1790207058 Albert Anthony Silva Counselor 80 Cove St, Riverside, RI 02915-3637 2017-07-07
1972040061 Tim O'connell Counselor 2085 Rustin Ave Bldg 1, Riverside, CA 92507-2498 2017-01-26
1215397757 Renee Machado Counselor 5484 Cedar St, Riverside, CA 92509-3746 2016-02-25
1831561299 Alysia Webb Counselor 11359 Dole Ct, Riverside, CA 92505-2353 2015-10-26
1053796110 Jessica Anne Pellegrin Counselor 3576 Arlington Ave Suite 102 & 104, Riverside, CA 92506-3907 2015-07-29
1346632379 Jessica Molina Counselor 6860 Brockton Ave # 9, Riverside, CA 92506-3821 2015-02-27
1144610494 Michael Julius Morris I Counselor 5870 Arlington Ave., Riverside, CA 92504 2015-01-26
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Competitor

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City RIVERSIDE
Zip Code 92508

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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