Provider Demographics
NPI:1619913936
Name:BLATTER, JO-ANNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JO-ANNE
Middle Name:
Last Name:BLATTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3891
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93130-3891
Mailing Address - Country:US
Mailing Address - Phone:805-682-7313
Mailing Address - Fax:
Practice Address - Street 1:2565 PUESTA DEL SOL
Practice Address - Street 2:SUITE 102
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-2936
Practice Address - Country:US
Practice Address - Phone:805-682-7313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS161761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW16176Medicare ID - Type Unspecified
CA37773Medicare UPIN