MEDICARE: KIARA LYNN BLANZA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YS0200X	School Counselor		CA

General Provider Information

NPI Number	:	1043174196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIARA LYNN BLANZA

Provider Business Mailing Address
First Line	:	30 VIA PESARO
Second Line	:
City	:	AMERICAN CANYON
State	:	CA
Zip	:	94503-1451
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6000 J ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-2605
Country	:	US
Telephone Number	:	707-373-0520
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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Directions to “ KIARA LYNN BLANZA ” Practice Location

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