Healthcare Provider Details

I. General information

NPI: 1790606184
Provider Name (Legal Business Name): REBECCA BLOUNT CPSS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 H ST STE 120
SACRAMENTO CA
95814-1817
US

IV. Provider business mailing address

901 H ST STE 120
SACRAMENTO CA
95814-1817
US

V. Phone/Fax

Practice location:
  • Phone: 279-297-8558
  • Fax:
Mailing address:
  • Phone: 279-297-8558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-KVFNEW
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: