Individual
JUSTIN ZARRETT BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15099 HESPERIAN BLVD, SAN LEANDRO, CA 94578-3545
(510) 276-0118
Mailing address
15099 HESPERIAN BLVD, SAN LEANDRO, CA 94578-3545
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
06/21/2021
Last updated
07/26/2023
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