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NPI Code Detail

MEDICARE: MARIBEL BLANCO

MEDICARE: MARIBEL BLANCO
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1831795624
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIBEL BLANCO
Provider Business Mailing Address
First Line : 3002 DOW AVE STE 206
Second Line :
City : TUSTIN
State : CA
Zip : 92780-7234
Country : US
Telephone Number : 657-294-5113
Fax Number :
Provider Business Practice Location Address
First Line : 3002 DOW AVE STE 206
Second Line :
City : TUSTIN
State : CA
Zip : 92780-7234
Country : US
Telephone Number : 657-294-5113
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2020
Last Update Date : 12/08/2020

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Directions to “ MARIBEL BLANCO ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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