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General NPI Number Information
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NPI Number | 1407095797
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Entity Type | Individual
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Provider Name | MR. ADRIAN X. BLISSFIELD
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Gender | Male
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Dates
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Enumeration Date | 02/11/2009
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Last Update Date | 02/11/2009
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Provider Practice Location Address
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Address Line | 4263 CALIFORNIA BLVD
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City | SANTA MARIA
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State | CA
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Zip | 93455-3503
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Country | US
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Telephone | 805-884-1629
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Fax |
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Provider Business Mailing Address
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Address Line | 209 S U ST #82
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City | LOMPOC
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State | CA
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Zip | 93436-6436
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Country | US
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Telephone | 419-419-8892
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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