Marie Blanchard, DMH

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 8493 Issued in CA

Practice address

3775 Beacon Ave
#241
Fremont, CA 94538-1465

Phone

(510) 790-0212

NPI assigned

Oct 18, 2005

Last updated

May 8, 2013By the provider in NPPES

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

Other names 1

• Dr. C Marie Blanchard Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

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  NPD (past)
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  dba Gentle Healing Space

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  • NPI 1609679281
  NPD (past)

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367971200000",
    "number": "1538158019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6486 PLUMMER AVE",
            "city": "NEWARK",
            "state": "CA",
            "postal_code": "945603721",
            "telephone_number": "510-790-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3775 BEACON AVE",
            "address_2": "#241",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381465",
            "telephone_number": "510-790-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCHARD",
        "first_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DMH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-18",
        "last_updated": "2013-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 8493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "C",
            "last_name": "BLANCHARD",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "DMH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Kathryn Blalock, DPT
• Keyanna Marie Bland
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• Bloch Care Ca LLC
• James Franklin Block, D.D.S.
• Shelli S Bodnar, M.D.

• Clinical Psychologist in Fremont, CA
• Providers in Fremont, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; 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.