Individual
BERNY BLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
21000 PLUMMER ST, CHATSWORTH, CA 91311-4903
(818) 884-6400
(818) 671-6950
Mailing address
206 N JACKSON ST, GLENDALE, CA 91206-4330
(818) 241-6780
(818) 241-6853
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
11/19/2018
Last updated
11/02/2023
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