Provider Demographics
NPI:1528190774
Name:BLANCALUZ-HANSEN, JANETTE (MA)
Entity Type:Individual
Prefix:
First Name:JANETTE
Middle Name:
Last Name:BLANCALUZ-HANSEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-2802
Mailing Address - Country:US
Mailing Address - Phone:415-928-6748
Mailing Address - Fax:
Practice Address - Street 1:101 TAYLOR ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-2802
Practice Address - Country:US
Practice Address - Phone:415-928-6748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health