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General NPI Number Information
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NPI Number | 1770123556
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Entity Type | Individual
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Provider Name | BLANCA ESTELA LEMUS
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Gender | Female
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Dates
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Enumeration Date | 01/09/2020
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Last Update Date | 01/09/2020
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Provider Practice Location Address
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Address Line | 1566 N 8TH PL
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City | PORT HUENEME
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State | CA
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Zip | 93041-2430
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Country | US
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Telephone | 805-889-4939
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Fax |
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Provider Business Mailing Address
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Address Line | 1566 N 8TH PL
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City | PORT HUENEME
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State | CA
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Zip | 93041-2430
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Country | US
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Telephone | 805-889-4939
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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 | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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