MEDICARE: STEPHANIE PATACHEE BLIAYA ASW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	134753	CA

General Provider Information

NPI Number	:	1861882748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE PATACHEE BLIAYA ASW

Provider Business Mailing Address
First Line	:	1617 E SAGINAW WAY STE 101
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93704-4458
Country	:	US
Telephone Number	:	559-216-2170
Fax Number	:

Provider Business Practice Location Address
First Line	:	1617 E SAGINAW WAY STE 101
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93704-4458
Country	:	US
Telephone Number	:	559-341-6110
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2015
Last Update Date	:	01/23/2026

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