Individual
LE'NIA NOEL BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 CROWN POINT CIR STE 120, GRASS VALLEY, CA 95945-9561
(530) 265-5811
Mailing address
760 S AUBURN ST STE C, GRASS VALLEY, CA 95945-4318
(916) 787-8860
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
CA
171M00000X
Case Manager/Care Coordinator
—
CA
172V00000X
Community Health Worker
—
—
372600000X
Adult Companion
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171R
—
CA
Enumeration date
10/02/2019
Last updated
04/20/2025
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