Healthcare Provider Details

I. General information

NPI: 1467131433
Provider Name (Legal Business Name): D'ARIA LANISE ANN BLANKENSHIP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2023
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

679 S NEW HAMPSHIRE AVE
LOS ANGELES CA
90005-1355
US

IV. Provider business mailing address

679 S NEW HAMPSHIRE AVE STE 400
LOS ANGELES CA
90005-1355
US

V. Phone/Fax

Practice location:
  • Phone: 213-639-2500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number132167
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: