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CHANELLE JOYCE BLAS NATIVIDAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4000 W METROPOLITAN DR, ORANGE, CA 92868-3504
(657) 383-3379
Mailing address
4000 W METROPOLITAN DR, ORANGE, CA 92868-3504

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
1659836419
CA
373H00000X
Day Training/Habilitation Specialist
Primary
CA

Other

Enumeration date
02/06/2019
Last updated
01/21/2026
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