Provider Demographics
NPI:1982875597
Name:BLASER, JANET IRENE (MA, MFT)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:IRENE
Last Name:BLASER
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 S CABRILLO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731-4029
Mailing Address - Country:US
Mailing Address - Phone:310-892-5315
Mailing Address - Fax:310-644-8910
Practice Address - Street 1:2403 S MORAY AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90732-4342
Practice Address - Country:US
Practice Address - Phone:310-892-5315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-22
Last Update Date:2008-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC43571106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist