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General NPI Number Information
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NPI Number | 1578455143
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Entity Type | Individual
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Provider Name | JAMES MICHAEL BLANKENSHIP CADC I
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Gender | Male
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Dates
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Enumeration Date | 07/17/2025
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 18975 HIGHWAY 94
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City | DULZURA
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State | CA
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Zip | 91917-1527
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Country | US
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Telephone | 619-335-2993
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Fax |
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Provider Business Mailing Address
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Address Line | 7814 CYPRESS DR
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City | SANTEE
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State | CA
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Zip | 92071-3703
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Country | US
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Telephone | 951-428-9385
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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