MISS LUPITA PENA-BALTAZAR QMHA NPI 1104050947

NPI Information

NPI: 1104050947
Provider Name: MISS LUPITA PENA-BALTAZAR, QMHA
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

PECOS Registration: Yes

Address:
1310 MERIDIAN DR
WOODBURN, OR
ZIP 97071
Phone: (503) 953-0310
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MISS Lupita Pena-baltazar, QMHA is a mental health counselor in Woodburn, OR with 7 years of experience. MISS Lupita Pena-baltazar, QMHA NPI is 1104050947. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1310 MERIDIAN DR
WOODBURN, OR
ZIP 97071-668
Phone: (503) 953-0310
Fax: (503) 386-0439

The NPI 1104050947 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 5/7/2009 and was last updated on 8/4/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			Yes
2	171M00000X	Case Manager/Care Coordinator				No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	L10733	OTHER		OREGON BOARD OF LICENSED SOCIAL WORKERS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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