MEDICARE: ANGEL MANASA BLOCHO

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	106H00000X	Marriage & Family Therapist	LMFT142776	CA

General Provider Information

NPI Number	:	1578007431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGEL MANASA BLOCHO

Provider Business Mailing Address
First Line	:	120 HARRIER AVE
Second Line	:
City	:	VALLEJO
State	:	CA
Zip	:	94590-3710
Country	:	US
Telephone Number	:	831-318-0298
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 HARRIER AVE
Second Line	:
City	:	VALLEJO
State	:	CA
Zip	:	94590-3710
Country	:	US
Telephone Number	:	831-428-2845
Fax Number	:

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

Provider Enumeration Date	:	12/12/2016
Last Update Date	:	05/27/2026

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Directions to “ ANGEL MANASA BLOCHO ” Practice Location

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