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Jillian M Blank
Student in an Organized Health Care Education/Training Program in Petaluma, California
NPI 1194438309

Jillian M Blank is a Student in an Organized Health Care Education/Training Program based in Santa Rosa, CA. Jillian M Blank practices in Petaluma, CA. The NPI Number for Jillian M Blank is 1194438309 and holds a License No. (California).

The current practice location address for Jillian M Blank is 1500 Petaluma Blvd S, Petaluma, CA and can be reached out via phone at 707-765-8488.

Location: 1500 Petaluma Blvd S, Petaluma, CA, 95405-7618
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1194438309
Provider Name
Jillian M Blank
Credential
Provider Entity Type
Individual
Gender
Female
Address
1500 Petaluma Blvd S, Petaluma, CA, 95405-7618
Phone Number
707-765-8488
Fax Number
Provider Enumeration Date
01/03/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1500 Petaluma Blvd S
City
Petaluma
State
California
Zip
94952-5545
Phone Number
707-765-8488
Fax Number
person
Provider Business Mailing Address Details
Address
1500 Petaluma Blvd S
City
Petaluma
State
California
Zip
94952-5545
Phone Number
707-765-8488
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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