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General NPI Number Information
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NPI Number | 1437790342
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Entity Type | Individual
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Provider Name | LE'NIA NOEL BLACKBURN
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Gender | Female
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Dates
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Enumeration Date | 10/02/2019
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Last Update Date | 04/20/2025
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Provider Practice Location Address
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Address Line | 500 CROWN POINT CIR STE 120
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City | GRASS VALLEY
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State | CA
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Zip | 95945-9561
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Country | US
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Telephone | 530-265-5811
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Fax |
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Provider Business Mailing Address
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Address Line | 760 S AUBURN ST STE C
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City | GRASS VALLEY
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State | CA
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Zip | 95945-4318
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Country | US
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Telephone | 916-787-8860
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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