Most Relevant Information
Provider Data
| NPI Number: | 1003057704 |
| Provider Name: | GINA BALLESTREOS |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/10/2009 |
| Last Updated: | 03/10/2009 |
Provider Practice Location
2535 KETTNER BLVD
SUITE 1A4
SAN DIEGO
CA
921011250
Practice Location Phone/Fax
| Phone: | 6196150701 |
| Fax: | 6196150705 |
Provider Mailing Location
2535 KETTNER BLVD
SUITE 1A4
SAN DIEGO
CA
921011250
Provider Mailing Phone/Fax
| Phone: | 6196150701 |
| Fax: | 6196150705 |