Nicholas Blasquez

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R184880922 Issued in CA

Practice address

5607 Mount Murphy Road
Garden Valley, CA 95633-9701

Phone

(530) 333-9460

NPI assigned

Jul 18, 2022

Last updated

Sep 28, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Progress House, Inc.

  • Substance Abuse Rehabilitation Facility
  • Garden Valley, CA
  • NPI 1801931878
  NPD

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

{
    "created_epoch": "1658102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1255066957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4980 HILLSDALE CIR STE ABC",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957625726",
            "telephone_number": "408-623-7713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5607 MOUNT MURPHY ROAD",
            "city": "GARDEN VALLEY",
            "state": "CA",
            "postal_code": "956339701",
            "telephone_number": "530-333-9460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4980 Hillsdale Cir Ste ABC",
            "address_purpose": "LOCATION",
            "city": "El Dorado Hills",
            "state": "CA",
            "postal_code": "957625726",
            "country_code": "US",
            "telephone_number": "408-623-7713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLASQUEZ",
        "first_name": "NICHOLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-18",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R184880922",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A Sacred Path
• Samantha Altavilla, PPS
• Jonathan Steven Bashline
• Damien Lee Benavidez, RADTI
• Jamie Danielle Benavidez, R1426050421
• Holly Brannon, SUDRC
• Raymonda Brazeal
• Jami Carricaburu
• Justin Flynn Cogbill
• Crystal Coury

• Addiction (Substance Use Disorder) Counselor in Garden Valley, CA
• Providers in Garden Valley, 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 Sep 28, 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.