Provider Demographics
NPI:1679652234
Name:BLECHER, MARCIA (PA)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:BLECHER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:MARCIA
Other - Middle Name:
Other - Last Name:CEESAY-SLATER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:10470 OLD PLACERVILLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:568 N SUNRISE AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3097
Practice Address - Country:US
Practice Address - Phone:916-865-1140
Practice Address - Fax:916-865-1145
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA17589363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant