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NPI Code Detail

MEDICARE: MS. MARIA ELAINE BLAHUT

MEDICARE: MS. MARIA ELAINE BLAHUT
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1760536882
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARIA ELAINE BLAHUT
Provider Business Mailing Address
First Line : 1400 N JOHNSON AVE STE 101
Second Line :
City : EL CAJON
State : CA
Zip : 92020-1651
Country : US
Telephone Number : 763-913-6101
Fax Number :
Provider Business Practice Location Address
First Line : 1400 N JOHNSON AVE STE 111
Second Line :
City : EL CAJON
State : CA
Zip : 92020-1651
Country : US
Telephone Number : 619-440-4801
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2007
Last Update Date : 03/16/2022

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Directions to “ MS. MARIA ELAINE BLAHUT ” Practice Location

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