Debra Blalock

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

120513 Issued in CA

Practice address

550 N Golden Circle Dr Ste a
Santa Ana, CA 92705-3977

Phone

(714) 210-9724

NPI assigned

Mar 18, 2024

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

Enrolled in CA

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.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Orange County Health Psychologists IncGroup PAC ID 4688990260, 59 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Orange County Health Psychologists, Inc.

  • Clinical Psychologist
  • Irvine, CA
  • NPI 1174945554
  Medicare reassignment Care Compare group NPD
• Kamala Thomas Psychological Services Corp

  • Adult Mental Health Clinic/Center
  • Irvine, CA
  • NPI 1144843814
  NPD

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1417716622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8442 VALENCIA DR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926476034",
            "telephone_number": "714-343-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 N GOLDEN CIRCLE DR STE A",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053977",
            "telephone_number": "714-210-9724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLALOCK",
        "first_name": "DEBRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "120513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Ann Black
• Michael Lewis Black, M.D.
• Sabrina Lee Blackney, D.P.T
• Denise Blair
• Christopher Armand Blais
• Anna Jo Blanchard, LCSW
• Nelly Blanco
• Rudy Albert Blanco, LMFT
• Geoff Blaylock
• Karen Bleacher

• Clinical Social Worker in Santa Ana, CA
• Providers in Santa Ana, 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 Mar 18, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.