Provider Demographics
NPI:1083502371
Name:BLACKSHER, FRANK DEAN
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:DEAN
Last Name:BLACKSHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7309 BAYOAK WAY
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95621-1305
Mailing Address - Country:US
Mailing Address - Phone:916-642-7800
Mailing Address - Fax:
Practice Address - Street 1:7309 BAYOAK WAY
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95621-1305
Practice Address - Country:US
Practice Address - Phone:916-642-7800
Practice Address - Fax:916-642-7800
Is Sole Proprietor?:No
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA167G00000X
167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician