Shantelle Denise Blackburn, is a
Social Worker based in San Jose, California. Shantelle Denise Blackburn is licensed to practice in California (license number 114520) and her current practice location is
645 Wool Creek Dr, San Jose, California. She can be reached at her office (for appointments etc.) via phone at
(408) 283-6000.
NPI number for Shantelle Denise Blackburn is 1164192886 and her current mailing address is 645 Wool Creek Dr, San Jose, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1164192886.
Healthcare Provider's Profile
Full Name | Shantelle Denise Blackburn |
---|
Gender | Female |
---|
Speciality | Social Worker |
---|
Location | 645 Wool Creek Dr, San Jose, California |
---|
Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1164192886
- Provider Enumeration Date: 09/14/2021
- Last Update Date: 09/03/2024
Medical Identifiers
Medical identifiers for Shantelle Denise Blackburn such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1164192886 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 114520 (California) | Secondary |
104100000X | Social Worker | 114520 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shantelle Denise Blackburn is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Shantelle Denise Blackburn, 645 Wool Creek Dr, San Jose, CA 95112-2617 Ph: () - | Shantelle Denise Blackburn, 645 Wool Creek Dr, San Jose, CA 95112-2617 Ph: (408) 283-6000 |
Reviews and Comments