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NPI Code Detail

MEDICARE: DAWN BLOSSFELD

MEDICARE: DAWN BLOSSFELD
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
11041C0700XClinical Social Worker82771CA

General Provider Information

NPI Number : 1871973909
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAWN BLOSSFELD
Provider Business Mailing Address
First Line : 1906 ORANGE TREE LN STE 230
Second Line :
City : REDLANDS
State : CA
Zip : 92374-4511
Country : US
Telephone Number : 510-317-1444
Fax Number :
Provider Business Practice Location Address
First Line : 1906 ORANGE TREE LN STE 230
Second Line :
City : REDLANDS
State : CA
Zip : 92374-4511
Country : US
Telephone Number : 510-317-1444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2015
Last Update Date : 10/31/2018

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Directions to “ DAWN BLOSSFELD ” Practice Location

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