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Individual

AMIRA BLAKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
815 HYDE ST, SAN FRANCISCO, CA 94109-5996
(415) 530-2571
Mailing address
815 HYDE ST, SAN FRANCISCO, CA 94109-5996

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
103TA0400X
Addiction (Substance Use Disorder) Psychologist
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
08/10/2022
Last updated
09/06/2023
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