Individual
MRS. AIDA BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1430 E COOLEY DR STE 240, COLTON, CA 92324-3936
(800) 675-6694
(909) 514-1613
Mailing address
10928 DAYLILLY ST, FONTANA, CA 92337-6846
(909) 938-6217
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
ACSW92007
CA
1041C0700X
Clinical Social Worker
Primary
LCSW118421
CA
Other
Enumeration date
01/31/2022
Last updated
04/13/2024
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