Silvia Eugenia Blanco

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

125519 Issued in CA

Practice address

1556 S Sultana Ave
Ontario, CA 91761-4238

Phone

(909) 418-6923

Fax

(909) 418-6937

NPI assigned

Jul 9, 2019

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1407408552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11430 CUMBERLAND LN",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917664671",
            "telephone_number": "909-576-0532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1556 S SULTANA AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917614238",
            "telephone_number": "909-418-6923",
            "fax_number": "909-418-6937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "SILVIA",
        "middle_name": "EUGENIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-09",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "125519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blakemore Inspired Wellness, Marriage and Family Services, PC.
• Sharayza Rachael Blakemore, LMFT, MBA
• Alexandria Blakeney
• Brian Blanco
• Debra Ann Blanco, PA-C
• Stephanie Blanco
• Vanessa Blanco
• Adriana Blas
• Samantha Blaska
• Blessed Hands Medical Group

• Clinical Social Worker in Ontario, CA
• Providers in Ontario, 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 Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.