Individual
CHRISJON AUGUSTUS BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1660 HOTEL CIR N STE 314, SAN DIEGO, CA 92108-2803
(619) 961-2120
Mailing address
1660 HOTEL CIR N STE 314, SAN DIEGO, CA 92108-2803
(619) 961-2120
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-18-60640
AZ
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
07/26/2018
Last updated
04/01/2025
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