Active NPI
Ian Davis Blair
- Counselor
- Ben Lomond, CA
National Provider Identifier
1699581330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 15411
- Practice address
- 10090 Highway 9 Ste 6
Ben Lomond, CA 95005-9251 - Phone
- (831) 704-6851
- NPI assigned
- Dec 7, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 15411 | CA | Primary |
Addresses
Primary practice location
10090 Highway 9 Ste 6
Ben Lomond, CA 95005-9251
Mailing address
151 Archer Way
Ben Lomond, CA 95005-9530
Phone (831) 334-4964
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733529600000",
"number": "1699581330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 ARCHER WAY",
"city": "BEN LOMOND",
"state": "CA",
"postal_code": "950059530",
"telephone_number": "831-334-4964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10090 HIGHWAY 9 STE 6",
"city": "BEN LOMOND",
"state": "CA",
"postal_code": "950059251",
"telephone_number": "831-704-6851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAIR",
"first_name": "IAN",
"middle_name": "DAVIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-12-07",
"last_updated": "2024-12-07",
"certification_date": "2024-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CA",
"license": "15411",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ben Lomond, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.