Black Oak Mine Unified School District

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

BLACK OAK MINE UNIFIED SCHOOL DISTRICT

Practice address

6530 Wentworth Springs Rd
Georgetown, CA 95634-9701

Phone

(530) 333-8320

NPI assigned

Sep 16, 2025

Last updated

Sep 16, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Clorisa Lynn Blish, CWCII WELLNESS COACH

Title

Wellness Coach

Phone

(530) 903-9188

Specialties & licenses 1

Addresses

Other names 1

• Bridget Isham Other name

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James Carley

  • Doula
  • Georgetown, CA
  • NPI 1457119091
  NPD
• Rebecca Sue Clark

  • Health & Wellness Coach
  • Georgetown, CA
  • NPI 1114837028
  NPD (past)
• Armando Jesus Rodriguez, CWC

  • Health & Wellness Coach
  • Georgetown, CA
  • NPI 1750237244
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1757980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757980800000",
    "number": "1043181563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9080 COUNTRY RD",
            "city": "GEORGETOWN",
            "state": "CA",
            "postal_code": "956349732",
            "telephone_number": "530-903-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6530 WENTWORTH SPRINGS RD",
            "city": "GEORGETOWN",
            "state": "CA",
            "postal_code": "956349701",
            "telephone_number": "530-333-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK OAK MINE UNIFIED SCHOOL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-16",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A",
        "authorized_official_last_name": "BLISH",
        "authorized_official_first_name": "CLORISA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "WELLNESS COACH",
        "authorized_official_telephone_number": "530-903-9188",
        "authorized_official_credential": "CWCII WELLNESS COACH"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridget Isham",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Black Oak Mine Unified School District
• Debra Boardman-Cheevers, FNP
• James Carley
• Rebecca Sue Clark
• Codyanne Marie Coombs, CLT

• Case Management Agency in Georgetown, CA
• Providers in Georgetown, CA by specialty
• Case Management Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.