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Individual

ELISE BLANTON-HUBBARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MOT, OTR/L

Contact information

Practice address
391 TAYLOR BLVD STE 100, PLEASANT HILL, CA 94523-2289
(925) 608-6550
Mailing address
1448 JOSEPHINE ST APT 2, BERKELEY, CA 94703-1108
(831) 277-8368

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
172V00000X
Community Health Worker
225X00000X
Occupational Therapist
OT-1656
ID
225X00000X
Occupational Therapist
OT16845
CA
225XM0800X
Mental Health Occupational Therapist
Primary
OT16845
CA

Other

Enumeration date
11/04/2016
Last updated
07/24/2024
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