NPI 1124485495 · live from the CMS NPI Registry
Elisabeth Anne Balcom, M.A.,CCC/SLP
Speech-Language Pathologist, in Madera, CA. National Provider Identifier 1124485495, active.
NPI record
| NPI | 1124485495 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Speech-Language Pathologist, 235Z00000X |
| Practice location | 12778 Road 37 1/2, Madera, CA 93636 |
| Practice phone | 559-430-8239 |
| Mailing address | 4560 Se International Way Ste 100, Milwaukie, OR 97222 |
| Enumerated | January 18, 2016 |
| Last updated | December 13, 2019 |
| Sole proprietor | Yes |
| Other names | Betsy Jorgensen |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Speech-Language Pathologist, primary | 235Z00000X | sp16633 (CA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.