Provider Demographics
NPI:1720231772
Name:BLAKEMAN, JOCELYN ELIZABETH (LAC)
Entity Type:Individual
Prefix:MS
First Name:JOCELYN
Middle Name:ELIZABETH
Last Name:BLAKEMAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5858 MOUNT ALIFAN DR
Mailing Address - Street 2:134
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-2723
Mailing Address - Country:US
Mailing Address - Phone:858-560-7773
Mailing Address - Fax:
Practice Address - Street 1:5858 MOUNT ALIFAN DR
Practice Address - Street 2:134
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-2723
Practice Address - Country:US
Practice Address - Phone:858-560-7773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5723171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist