Individual
BLAKE STEVEN BOULDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
28141 BRANCH RD, CASTAIC, CA 91384-3002
(818) 731-8759
Mailing address
28141 BRANCH RD, CASTAIC, CA 91384-3002
(818) 731-8759
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95038915
CA
Other
Enumeration date
03/13/2026
Last updated
03/13/2026
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