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Contact Information

JENNIFER D BLECK
2725 MENDOCINO AVE
SANTA ROSA, CA95403
 Phone: 707-545-4537
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for JENNIFER D BLECK · (Female)

NPI # 1326683350
Status Active
Credentials
Entity Individual
Enumeration date 11/13/2019
Last updated 01/06/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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