Provider Demographics
NPI:1881856375
Name:BLAKE, APRIL FAY (ND)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:FAY
Last Name:BLAKE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 LARKSPUR LANDING CIR
Mailing Address - Street 2:SUTE 200
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939-1757
Mailing Address - Country:US
Mailing Address - Phone:415-578-3095
Mailing Address - Fax:415-291-0489
Practice Address - Street 1:900 LARKSPUR LANDING CIR
Practice Address - Street 2:SUTE 200
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939-1757
Practice Address - Country:US
Practice Address - Phone:415-578-3095
Practice Address - Fax:415-291-0489
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND299175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAND229OtherLICENSE