Provider Demographics
NPI:1679625073
Name:BALLANTI, STEVEN (MSW)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:BALLANTI
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 WATT AVE
Mailing Address - Street 2:SUITE 180
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-2667
Mailing Address - Country:US
Mailing Address - Phone:916-482-2216
Mailing Address - Fax:
Practice Address - Street 1:3550 WATT AVE
Practice Address - Street 2:SUITE 180
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-2667
Practice Address - Country:US
Practice Address - Phone:916-482-2216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 89231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical