Provider Demographics
NPI:1679746358
Name:BLANKENSHIP, ELAINA J-NELL (DPT)
Entity Type:Individual
Prefix:
First Name:ELAINA
Middle Name:J-NELL
Last Name:BLANKENSHIP
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:ELAINA
Other - Middle Name:J-NELL
Other - Last Name:KANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:3205 HURLEY WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864-3853
Mailing Address - Country:US
Mailing Address - Phone:916-844-4228
Mailing Address - Fax:916-679-3100
Practice Address - Street 1:3205 HURLEY WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95864-3853
Practice Address - Country:US
Practice Address - Phone:916-844-4228
Practice Address - Fax:916-679-3100
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34580225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist