Provider Demographics
NPI:1447574603
Name:BLANCHFIELD, SHEILA ANN (MFT)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:ANN
Last Name:BLANCHFIELD
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 MARIN ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4260
Mailing Address - Country:US
Mailing Address - Phone:805-492-2930
Mailing Address - Fax:
Practice Address - Street 1:501 MARIN ST
Practice Address - Street 2:SUITE 108
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4260
Practice Address - Country:US
Practice Address - Phone:805-492-2930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 25337106H00000X
CAMFC25337106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist