Healthcare Provider Details

I. General information

NPI: 1023972023
Provider Name (Legal Business Name): JANELL AKILAH BLAKE APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 CRANSTON DR UNIT 227
ESCONDIDO CA
92025-7047
US

IV. Provider business mailing address

5290 OVERPASS RD STE 220
SANTA BARBARA CA
93111-2051
US

V. Phone/Fax

Practice location:
  • Phone: 929-227-1429
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC12546
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: