Individual
MARYANN BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
411 30TH ST STE 314, OAKLAND, CA 94609-3303
(510) 273-4200
(510) 273-8340
Mailing address
5674 STONERIDGE DR STE 116, PLEASANTON, CA 94588-8536
(925) 520-0005
(925) 520-0010
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
635931
CA
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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