| Ilene Blaisch | |
|
161 Avenida Cabrillo San Clemente CA 92672-4040 | |
| (949) 910-5654 | |
| Not Available |
| Full Name | Ilene Blaisch |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 161 Avenida Cabrillo, San Clemente, California |
| Authorized Official Name and Position | Ilene Blaisch (PSYCHOTHERAPIST) |
| Authorized Official Contact | 9499105654 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ilene Blaisch 161 Avenida Cabrillo San Clemente CA 92672-4040 Ph: (949) 910-5654 | Ilene Blaisch 161 Avenida Cabrillo San Clemente CA 92672-4040 Ph: (949) 910-5654 |
| NPI Number | 1104155290 |
|---|---|
| Provider Enumeration Date | 12/18/2009 |
| Last Update Date | 12/18/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104155290 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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