Individual
MR. BRIAN HOWARD ANTHONY BLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
140 ARBOR DR, SAN DIEGO, CA 92103-2007
(619) 543-6904
Mailing address
140 ARBOR DR, SAN DIEGO, CA 92103-2007
(619) 543-6904
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
71869
CA
1041C0700X
Clinical Social Worker
Primary
87306
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/13/2015
Last updated
02/20/2019
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