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General NPI Number Information
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NPI Number | 1487817771
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Entity Type | Individual
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Provider Name | MRS. LILIBETH E. BLAIR
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Gender | Female
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Dates
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Enumeration Date | 07/07/2008
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Last Update Date | 07/07/2008
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Provider Practice Location Address
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Address Line | 2001 THE ALAMEDA
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City | SAN JOSE
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State | CA
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Zip | 95126-1136
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Country | US
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Telephone | 408-254-9960
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Fax |
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Provider Business Mailing Address
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Address Line | 20001 SHADOW CREEK CIR
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City | CASTRO VALLEY
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State | CA
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Zip | 94552-3744
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Country | US
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Telephone | 510-886-1841
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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 | PT31117
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License Number State | CA
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