Martin Blanco, DACII

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Corning, CA

NPI 1063673754 · NPPES record last updated Jun 24, 2008

Key facts

NPI
1063673754
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
A3765798 (CA)
Practice address
1600 Solano St
Corning, CA 96021-2952
Phone
(530) 824-4890
Fax
(530) 824-8443
NPI assigned
Jun 24, 2008
Sex
Male
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

State licenses

LicenseStateTypeSpecialty
A3765798CAMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X A3765798 CA Yes

Addresses

Primary practice location

1600 Solano St
Corning, CA 96021-2952

Mailing address

PO Box 400
Red Bluff, CA 96080-0400
Phone (530) 824-4890

Other providers in Corning, CA

All providers in Corning, CA · Addiction (Substance Use Disorder) Counselor in California

Sources for this page

Verify at the official NPI Registry.