Healthcare Provider Details

I. General information

NPI: 1801442611
Provider Name (Legal Business Name): CHRISTOPHER ARMAND BLAIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2019
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W SANTA ANA BLVD STE 100
SANTA ANA CA
92701-4134
US

IV. Provider business mailing address

PO BOX 2283
CHINO HILLS CA
91709-0077
US

V. Phone/Fax

Practice location:
  • Phone: 714-480-6660
  • Fax:
Mailing address:
  • Phone: 909-631-8422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW131643
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: