Search › California › 104100000X
Mark Ebalo, PP-2
NPI 1205349255 · on the registry since 2017
Practice
- Address
- 1356 Ridder Park Dr
San Jose, CA 95131 - Phone
- (669) 205-2512
- Organisation at this address
- Community Solutions For Children, Families And Individuals
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 56
Additional practice sites
- 185 Martinvale Ln, San Jose, CA
- 1360 E Lassen Ave, Chico, CA
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-06-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California