Dana Jackson Bloch

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMF92159 Issued in CA

Practice address

555 Northgate Dr Ste 100
Buckelew Programs
San Rafael, CA 94903-3696

Phone

(415) 491-5700

NPI assigned

Aug 19, 2016

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1669927604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 NORTHGATE DR STE 100",
            "address_2": "BUCKELEW PROGRAMS",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 NORTHGATE DR STE 100",
            "address_2": "BUCKELEW PROGRAMS",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033696",
            "telephone_number": "415-491-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCH",
        "first_name": "DANA",
        "middle_name": "JACKSON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-19",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "IMF92159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chase Bishov, AMFT
• Robin Laura Bitner, M.D.
• Rosalind Tikvah Black, ASW
• Julie Blanchard
• Robert Foster Bliss, DC
• Kaleybra Block
• Stephanie Ann Bloesch, M.F.T.
• Shannon Bloodsaw
• Robyn Bloom
• Cooper Wallace Bloyd, MD

• Mental Health Counselor in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; 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.