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Blake Edward Laszlo

Peer Specialist in Riverside, CA. Individual provider (NPI-1).

NPI number1003595752
StatusActive
Last updated in NPPESOct 22, 2024

Details

NPI
1003595752
Entity type
Individual (NPI-1)
Name
Mr. Blake Edward Laszlo
Sex
Male
Sole proprietor
No
Enumeration date
Jul 11, 2023
Certification date
Oct 22, 2024
Last updated
Oct 22, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
175T00000X Peer Specialist–CAYes
172V00000X Community Health Worker––

Practice location

3125 Myers St
Riverside, CA 92503-5527

Phone 714-943-6505

Mailing address

3125 Myers St
Riverside, CA 92503-5527

Phone 714-943-6505

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