Dana Jackson Bloch
Counselor, Mental Health in San Rafael, CA. Individual provider (NPI-1).
NPI number1669927604
StatusActive
Last updated in NPPESSep 8, 2016
Details
- NPI
- 1669927604
- Entity type
- Individual (NPI-1)
- Name
- Dana Jackson Bloch
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 19, 2016
- Last updated
- Sep 8, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | IMF92159 | CA | Yes |
Practice location
555 Northgate Dr Ste 100Buckelew Programs
San Rafael, CA 94903-3696
Phone 415-491-5700
Mailing address
555 Northgate Dr Ste 100Buckelew Programs
San Rafael, CA 94903-3696
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