Christine Chang Blake, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY17494 Issued in CA

Practice address

1040 Noel Dr Ste 105
Menlo Park, CA 94025-3357

Phone

(650) 218-3018

NPI assigned

Jan 19, 2007

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

Other names 1

• Christine M Chang Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423612800000",
    "number": "1740333954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 NOEL DR STE 105",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940253357",
            "telephone_number": "650-218-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 NOEL DR STE 105",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940253357",
            "telephone_number": "650-218-3018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "CHRISTINE",
        "middle_name": "CHANG",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2015-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY17494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "CHANG",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sandra Birdwell, MD
• Celeste Phaneuf Birkhofer, MFT, PHD
• Julia Birt, PSYD
• Black Granola
• Stewart Blain, PSY.D.
• Maggie Christine Blake, DPT
• Blanca Sana
• Katherine Elliott Blank, OTR/L
• Michael Gerald Bloch, ACSW
• Daniel Michael Blonigen, PH.D.

• Psychologist in Menlo Park, CA
• Providers in Menlo Park, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; 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.