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Organization
JENNIFER BLUM PSYD LICENSED PSYCHOLOGIST PC
Active
Organization
JENNIFER BLUM PSYD LICENSED PSYCHOLOGIST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BLUM PSYD (OWNER)
(707) 331-4769
Entity
Organization
Contact information
Practice address
1144 SONOMA AVE STE 104, SANTA ROSA, CA 95405-4812
(707) 331-4769
Mailing address
484 CORNISH LN, ANGWIN, CA 94508-9736
(707) 331-4769
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
27164
CA
Other
Enumeration date
11/18/2015
Last updated
11/18/2015
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