Ilene Blaisch

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ILENE BLAISCH

Practice address

161 Avenida Cabrillo
San Clemente, CA 92672-4040

Phone

(949) 910-5654

NPI assigned

Dec 18, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Ilene Blaisch, LCSW

Title

Psychotherapist

Phone

(949) 910-5654

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1261094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261094400000",
    "number": "1104155290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 AVENIDA CABRILLO",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724040",
            "telephone_number": "949-910-5654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 AVENIDA CABRILLO",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724040",
            "telephone_number": "949-910-5654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILENE BLAISCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-18",
        "last_updated": "2009-12-18",
        "status": "A",
        "authorized_official_last_name": "BLAISCH",
        "authorized_official_first_name": "ILENE",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "949-910-5654",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2009; 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.