Amira Blake

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

815 Hyde St
San Francisco, CA 94109-5996

Phone

(415) 530-2571

NPI assigned

Aug 10, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1225766009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 HYDE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941095996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 HYDE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941095996",
            "telephone_number": "415-530-2571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1411 E 31st St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946021018",
            "country_code": "US",
            "telephone_number": "510-437-5078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "AMIRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-10",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Randall Blair, MD, PHD
• Jacob Ryan Blair
• Kayla Blair
• Yvette Blair
• Blake Rawdin, MD, a Professional Medical Corporation
• Gisel Blake
• Nancy Clare Blake
• Rasheedah Blake
• Richard Lawrence Blake, D.P.M.
• Collin Blakely, MD

• Student in an Organized Health Care Education/Training Program in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.