# PSYCHIATRIC NURSING PRESCRIBER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Personal Practitioners
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275387532
- **Authorized official:** REBECCA BLAKESLEY PMHNP (PMHNP)
- **Authorized official phone:** (415) 605-5760

## Contact information

- **Practice address:** 1 SANSOME ST FL 35, SAN FRANCISCO, CA 94104-4436
- **Practice address phone:** (415) 605-5760
- **Mailing address:** 836 SOUTHAMPTON ROAD, STE B \#115, BENICIA, CA 94510
- **Mailing address phone:** (415) 605-5760

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/15/2024
- **Last updated:** 04/15/2024