Provider Demographics
NPI:1083749733
Name:BOERSMA, BLANCA DANIELLE (BA, MS)
Entity Type:Individual
Prefix:MS
First Name:BLANCA
Middle Name:DANIELLE
Last Name:BOERSMA
Suffix:
Gender:F
Credentials:BA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3055 PACIFIC AVE
Mailing Address - Street 2:#4
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1042
Mailing Address - Country:US
Mailing Address - Phone:510-978-8378
Mailing Address - Fax:
Practice Address - Street 1:1034 OAK GROVE RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-3225
Practice Address - Country:US
Practice Address - Phone:925-603-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool