Ilene M. Blaisch, MSW, LSCW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10668 Issued in CA

Practice address

161 Avenida Cabrillo
San Clemente, CA 92672-4040

Phone

(949) 910-5654

NPI assigned

Apr 15, 2009

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239753600000",
    "number": "1356584635",
    "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": {
        "last_name": "BLAISCH",
        "first_name": "ILENE",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "MSW, LSCW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-15",
        "last_updated": "2009-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "10668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delaney Bien
• Staci Billy, RDHAP
• Kristin Bjorkman, M.S. CCC-SLP
• Theresa Black, MA
• Timothy Black, PHARMD
• Kristin Blaney, MA, MFT
• Jack Holland Boatman, DDS
• Destiny Lee Bochinski, P.T., D.P.T.
• Tera Lynn Bodo, RN
• Body Mind Spirit Iop Inc

• Clinical Social Worker in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.