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General NPI Number Information
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NPI Number | 1982820486
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Entity Type | Individual
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Provider Name | LORRAINE CHRISTIE BLUMENTHAL LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 06/18/2021
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Provider Practice Location Address
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Address Line | 399 DRAKE AVE
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City | MONTEREY
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State | CA
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Zip | 93940-7504
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Country | US
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Telephone | 831-421-1130
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Fax |
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Provider Business Mailing Address
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Address Line | 160 MCKENZIE CREEK RD
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City | SCOTTS VALLEY
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State | CA
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Zip | 95066-3114
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Country | US
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Telephone | 831-227-5815
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW60586
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License Number State | CA
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