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General NPI Number Information
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NPI Number | 1861647455
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Entity Type | Individual
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Provider Name | WILLIAM ANTHONY ANDERSON BLAIR JR. PH.D.
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Gender | Male
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Dates
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Enumeration Date | 11/24/2008
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Last Update Date | 11/30/2024
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Provider Practice Location Address
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Address Line | 803 DAVID DR
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City | CHULA VISTA
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State | CA
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Zip | 91910-6402
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Country | US
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Telephone | 334-332-6540
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Fax | 888-527-7925
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Provider Business Mailing Address
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Address Line | 803 DAVID DR
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City | CHULA VISTA
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State | CA
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Zip | 91910-6402
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Country | US
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Telephone | 619-796-5263
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Fax | 888-527-7925
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY-004370
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY-35278
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License Number State | CA
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