MARK EBALO PP-2
NPI 1205349255
Social Worker in San Jose, CA

Q: What is Mark Ebalo's NPI number?

The NPI number for Mark Ebalo is 1205349255. It was assigned to this individual provider in the NPPES registry on November 13, 2017.

Q: What is Mark Ebalo's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Q: When was this NPI record last updated?

The NPPES record for Mark Ebalo was last updated on June 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 13, 2017

1356 RIDDER PARK DR, SAN JOSE, CA 95131(669) 205-2512 Get Directions Write a Review

NPPES record last updated: June 20, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 20, 2023, Oct 23, 2019, Nov 13, 2017 (3 updates tracked since 2017).

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About Mark Ebalo Pp-2 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK EBALO PP-2 (NPI 1205349255) is an individual social worker in San Jose, California and active in the NPI registry since November 2017. He maintains 2 additional practice locations.

NPPES Registry Identity

NPI1205349255

Entity TypeIndividualMale

Primary Taxonomy104100000X

Provider Legal NameMARK EBALOCredential: PP-2

Location Address1356 RIDDER PARK DRSan Jose, CA 95131-2313

Mailing Address1356 Ridder Park DrSan Jose, CA 95131-2313 · (669) 205-2512

Phone(669) 205-2512

Sole ProprietorNo

Enumeration DateNovember 13, 2017

Last NPPES UpdateJune 20, 20233 updates tracked since enumeration

NPPES CertifiedJune 20, 2023

✔ NPI 1205349255 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

Definition

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

1356 RIDDER PARK DR, San Jose, CA 95131

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Secondary Practice Locations 2

Location 1185 Martinvale LnSan Jose, CA 95119-1319 · Phone (408) 207-0070

Location 21360 E Lassen AveChico, CA 95973 · Phone (530) 267-1766

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GERARDO GUZMAN VITELA

Rehabilitation Practitioner