Provider Demographics
NPI:1083692354
Name:BLANCO, AMIE MARIE (MS)
Entity Type:Individual
Prefix:
First Name:AMIE
Middle Name:MARIE
Last Name:BLANCO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 RIVERTON DR
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-1429
Mailing Address - Country:US
Mailing Address - Phone:415-885-7481
Mailing Address - Fax:
Practice Address - Street 1:2330 POST ST
Practice Address - Street 2:SUITE 610
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3465
Practice Address - Country:US
Practice Address - Phone:415-885-7481
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS