Blake, Dorene G
Blake, Dorene G is an individual health care provider with primary practice located at 820 Bay Avenue Suite 132, Capitola CA 95010. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Blake, Dorene G can be contacted via phone (831) 475-1615.Contact Information
Primary practice address
820 Bay Avenue Suite 132
Capitola CA 95010
Phone: (831) 475-1615
Fax: (831) 476-2433
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | MFT27688 | California |
Profile Details
| NPI number | 1225191745 |
|---|---|
| LBN Legal business name | Blake, Dorene G |
| Credentials | MA MFT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 18th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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