| Penny Blazej Licensed Clinical Social Worker Prof Corp | |
|
28714 Valley Center Road Suite E Valley Center CA 92082 | |
| (760) 685-3403 | |
| (760) 751-8650 |
| Full Name | Penny Blazej Licensed Clinical Social Worker Prof Corp |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 28714 Valley Center Road, Valley Center, California |
| Authorized Official Name and Position | Penny Annette Blazej (OWNER) |
| Authorized Official Contact | 7606853403 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Penny Blazej Licensed Clinical Social Worker Prof Corp 28714 Valley Center Road Suite E Valley Center CA 92082 Ph: (760) 685-3403 | Penny Blazej Licensed Clinical Social Worker Prof Corp 28714 Valley Center Road Suite E Valley Center CA 92082 Ph: (760) 685-3403 |
| NPI Number | 1821279043 |
|---|---|
| Provider Enumeration Date | 11/15/2007 |
| Last Update Date | 11/15/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821279043 | NPI | - | NPPES |
| LC5215700 | Other | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 21570 (California) | Primary |
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