Individual
MR. JAMES L BLAYLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT-LMHW
Contact information
Practice address
3133 N MILLBROOK AVE, FRESNO, CA 93703-1425
(559) 600-9180
Mailing address
1200 MISSION ST, MADERA, CA 93638-2231
(559) 623-3582
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
35805
CA
167G00000X
Licensed Psychiatric Technician
—
—
Other
Enumeration date
04/14/2020
Last updated
12/08/2020
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