Individual
DR. DANIEL ROBERT BLAESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1350 COLUMBIA ST UNIT 402, SAN DIEGO, CA 92101-3455
(619) 804-1669
(619) 804-1669
Mailing address
1350 COLUMBIA ST UNIT 402, SAN DIEGO, CA 92101-3455
(619) 804-1669
(619) 804-1669
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY17107
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY17107
LICENSE
CA
Enumeration date
03/17/2006
Last updated
11/15/2019
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