Individual
BLAYKE GABRIELLA ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDRC
Contact information
Practice address
3340 KEMPER ST STE 105, SAN DIEGO, CA 92110-4907
(619) 523-8121
(619) 523-8742
Mailing address
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541
(619) 515-2300
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13803
CA
Other
Enumeration date
09/13/2022
Last updated
03/13/2023
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