Provider Demographics
NPI:1134741317
Name:BLAIR WEST, JAMES ROBERT (MSW, ASW)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:BLAIR WEST
Suffix:
Gender:M
Credentials:MSW, ASW
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:ROBERT
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, ASW
Mailing Address - Street 1:PO BOX 2011
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-0201
Mailing Address - Country:US
Mailing Address - Phone:707-673-6667
Mailing Address - Fax:
Practice Address - Street 1:1303 JEFFERSON ST STE 710A
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-2449
Practice Address - Country:US
Practice Address - Phone:415-326-3969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-11
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA941871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical