Individual
ALISE NICOLE BLACKMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
60 GOLD CREST CT, PITTSBURG, CA 94565-6500
(925) 267-2059
Mailing address
1200 W 10TH ST, ANTIOCH, CA 94509-1407
(925) 783-9369
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
07/10/2025
Last updated
08/27/2025
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