Active NPI
Penny Blazej Licensed Clinical Social Worker Prof Corp
- Clinical Social Worker
- Valley Center, CA
National Provider Identifier
1821279043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 21570
- Legal business name
- PENNY BLAZEJ LICENSED CLINICAL SOCIAL WORKER PROF CORP
- Practice address
- 28714 Valley Center Road
Suite E
Valley Center, CA 92082 - Phone
- (760) 685-3403
- Fax
- (760) 751-8650
- NPI assigned
- Nov 15, 2007
- Organization subpart
- Yes
- Parent organization
- PENNY BLAZEJ LICENSED CLINICAL SOCIAL WORKER PROF CORP
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Penny Annette Blazej, LCSW BCD
- Title
- Owner
- Phone
- (760) 685-3403
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 21570 | CA | Primary |
Addresses
Primary practice location
28714 Valley Center Road
Suite E
Valley Center, CA 92082
Mailing address
28714 Valley Center Road
Suite E
Valley Center, CA 92082
Phone (760) 685-3403
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LC5215700 | Other | BLUE CROSS BLUE SHIELD |
National Provider Directory
National Provider Directory- Part of
- Valley Center Counseling Inc
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- Escondido, CA
- NPI 1316936529
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195084800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1195084800000",
"number": "1821279043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28714 VALLEY CENTER ROAD",
"address_2": "SUITE E",
"city": "VALLEY CENTER",
"state": "CA",
"postal_code": "92082",
"telephone_number": "760-685-3403",
"fax_number": "760-751-8650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28714 VALLEY CENTER ROAD",
"address_2": "SUITE E",
"city": "VALLEY CENTER",
"state": "CA",
"postal_code": "92082",
"telephone_number": "760-685-3403",
"fax_number": "760-751-8650"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PENNY BLAZEJ LICENSED CLINICAL SOCIAL WORKER PROF CORP",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PENNY BLAZEJ LICENSED CLINICAL SOCIAL WORKER PROF CORP",
"enumeration_date": "2007-11-15",
"last_updated": "2007-11-15",
"status": "A",
"authorized_official_last_name": "BLAZEJ",
"authorized_official_first_name": "PENNY",
"authorized_official_middle_name": "ANNETTE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "760-685-3403",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "LCSW BCD"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "21570",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "LC5215700",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Valley Center, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.