Bryan Paul Blackwell, CHC

Individual provider Active NPI Health & Wellness Coach · Yucca Valley, CA

NPI 1356035604 · NPPES record last updated Jun 7, 2023

Key facts

NPI
1356035604
Entity type
Individual (NPI type 1)
Primary specialty
Health & Wellness Coach 171400000X
Practice address
6801 Sioux Ave
Yucca Valley, CA 92284-2679
Phone
(760) 895-8233
NPI assigned
Jun 7, 2023
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X NY Yes

Addresses

Primary practice location

6801 Sioux Ave
Yucca Valley, CA 92284-2679

Mailing address

6801 Sioux Ave
Yucca Valley, CA 92284-2679
Phone (760) 895-8233

Other providers in Yucca Valley, CA

All providers in Yucca Valley, CA · Health & Wellness Coach in California

Sources for this page

Verify at the official NPI Registry.