Stanley Kuhio Blondek, PSY.D., LAADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LCI04950320 Issued in CA

Practice address

4300 Auburn Blvd Ste 107
Sacramento, CA 95841-4103

Phone

(916) 830-2224

NPI assigned

Jan 30, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1643500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1194478263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 AUBURN BLVD STE 107",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958414103",
            "telephone_number": "916-830-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 AUBURN BLVD STE 107",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958414103",
            "telephone_number": "916-830-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLONDEK",
        "first_name": "STANLEY",
        "middle_name": "KUHIO",
        "name_prefix": "Dr.",
        "credential": "PSY.D., LAADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-30",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "LCI04950320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tera Jean Block
• Jill Blodget, FNP
• James Remund Blodgett
• Kevin Douglas Blom
• Thad Blondefield
• Bloom and Bee LLC
• Bloom Care Network, Inc.
• Bloom Ink Collective, LLC
• Andrew Jason Bloom, PA-C
• Evan D. Bloom, MD

• Addiction (Substance Use Disorder) Counselor in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; 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.