Provider Demographics
NPI:1972511335
Name:BALL, ALIA BETH (LMFT)
Entity type:Individual
Prefix:MRS
First Name:ALIA
Middle Name:BETH
Last Name:BALL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 LONETREE BLVD STE 107108J
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-3772
Mailing Address - Country:US
Mailing Address - Phone:916-337-7187
Mailing Address - Fax:
Practice Address - Street 1:5701 LONETREE BLVD STE 107108J
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-3772
Practice Address - Country:US
Practice Address - Phone:916-337-7187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46062101YM0800X, 106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health