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General NPI Number Information
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NPI Number | 1851459192
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Entity Type | Individual
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Provider Name | JEANETTE ELIZABETH BLAND M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 10/15/2008
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Provider Practice Location Address
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Address Line | 851 FREMONT AVE SUITE 98
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City | LOS ALTOS
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State | CA
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Zip | 94024
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Country | US
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Telephone | 650-494-9360
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Fax | 650-559-5926
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Provider Business Mailing Address
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Address Line | 851 FREMONT AVE #98
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City | LOS ALTOS
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State | CA
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Zip | 94024
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Country | US
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Telephone | 650-494-9360
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Fax | 650-559-5926
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G65006
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License Number State | CA
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