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General NPI Number Information
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NPI Number | 1467368274
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Entity Type | Individual
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Provider Name | BELLA R BLAYLOCK
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Gender | Female
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Dates
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Enumeration Date | 08/21/2026
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Last Update Date | 08/21/2026
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Provider Practice Location Address
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Address Line | 1207 CARLSBAD VILLAGE DR STE N
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City | CARLSBAD
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State | CA
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Zip | 92008-1958
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Country | US
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Telephone | 760-717-2630
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Fax |
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Provider Business Mailing Address
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Address Line | 3185 SANDY PL
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City | CARLSBAD
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State | CA
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Zip | 92008-1139
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Country | US
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Telephone | 760-717-2630
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State | CA
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