Individual
VANESSA ANNE BLASIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
320 SANTA FE DR STE 108, ENCINITAS, CA 92024-5141
(760) 436-4558
(858) 429-7926
Mailing address
PO BOX 33865, SAN DIEGO, CA 92163-3865
(858) 888-7700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA54781
CA
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
08/25/2017
Last updated
07/23/2021
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