Matthew Blankers, ACSW
Individual provider Active NPI Social Worker · Bishop, CA
NPI 1487217816 · NPPES record last updated Apr 22, 2019
Key facts
- NPI
- 1487217816
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- ASW87552 (CA)
- Practice address
- 162J Grove St
Bishop, CA 93514-2640 - Phone
- (760) 873-6533
- Fax
- (760) 873-3277
- NPI assigned
- Apr 22, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW87552 | CA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Inyo | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | ASW87552 | CA | Yes |
Addresses
Primary practice location
162J Grove St
Bishop, CA 93514-2640
Mailing address
162J Grove St
Bishop, CA 93514-2640
Phone (760) 873-6533
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ASW87552 | Other | CA | CALIFORNIA |
Other providers in Bishop, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.