Heather Rain Blackburn, RADT
Individual provider Active NPI Counselor · Placerville, CA
NPI 1053782748 · NPPES record last updated Oct 7, 2015
Key facts
- NPI
- 1053782748
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 2844 Coloma St
Placerville, CA 95667-4406 - Phone
- (530) 644-3758
- Fax
- (530) 644-3782
- NPI assigned
- Oct 7, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
2844 Coloma St
Placerville, CA 95667-4406
Mailing address
PO Box 586
Camino, CA 95709-0586
Phone (530) 644-3758
Other providers in Placerville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.