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Individual

ANNA BLUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
850 E. FOOTHILL BLVD., 124-D, RIALTO, CA 92376
(909) 421-9475
Mailing address
15218 SUMMIT AVE STE 300-260, FONTANA, CA 92336-0232
(906) 560-9797

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
ASW110371
CA
104100000X
Social Worker
Primary
ASW110371
CA

Other

Enumeration date
01/07/2008
Last updated
09/11/2023
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