Individual
MARTHA YESENIA BLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6809 INDIANA AVE STE 154, RIVERSIDE, CA 92506-4221
(951) 441-7649
Mailing address
41308 SHADOW PALM WAY, HEMET, CA 92544-8293
(951) 743-8189
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/23/2022
Last updated
08/23/2022
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