Basic Information
| Provider Information | |||||||||
| NPI: | 1679953921 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BALINGIT | ||||||||
| FirstName: | MARIA OMAYMA | ||||||||
| MiddleName: | |||||||||
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| Credential: | BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3731 SIXTH AVE. SUITE 100 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921035216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6195506368 | ||||||||
| FaxNumber: | 6193747134 | ||||||||
| Practice Location | |||||||||
| Address1: | 3731 SIXTH AVE. SUITE 100 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921035216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6195506368 | ||||||||
| FaxNumber: | 6193747134 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2015 | ||||||||
| LastUpdateDate: | 09/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 1-15-20739 | CA | Y | Behavioral Health & Social Service Providers | Behavioral Analyst | 253Z00000X | 1-15-20739 | CA | N | Agencies | In Home Supportive Care |
No ID Information.