DR. GARY A BLANK (NPI# 1316160906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316160906 |
| Entity Type | Individual |
| Full Name | DR. GARY A BLANK |
| Credential | PH.D. |
| Practice Address |
2455 Bennett Valley Rd Suite 208b Santa Rosa CA 95404-5663 |
| Practice Telephone | 7075262525 |
| Practice Fax Number | 7075262593 |
| Mailing Telephone | 7075262525 |
| Mailing Fax Number | 7075262593 |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY3303 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770522344 | Gary Richard Blank | Podiatrist | 41 Juneau Blvd, Woodbury, NY 11797-2615 | 2006-06-06 |
| 1437320249 | Gary Fred Blank | Social Worker | 323 W 6th St, Okmulgee, OK 74447-5019 | 2008-03-19 |
| Street Address |
2455 BENNETT VALLEY RD SUITE 208B |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95404-5663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639169576 | Carol Weser | Psychologist | 2455 Bennett Valley Rd, Suite B-208, Santa Rosa, CA 95404-5663 | 2005-10-23 |
| 1831566546 | Andrew E Pearson | Psychologist | 2455 Bennett Valley Rd, Ste B208, Santa Rosa, CA 95404-5667 | 2015-08-28 |
| 1568806560 | Joseph Christopher Puentes | Psychologist | 2455 Bennett Valley Rd, Waterfall Towers Suite B-208, Santa Rosa, CA 95404-5663 | 2013-04-20 |
| 1477887024 | Kofi E Inkabi | Anesthesiology | 2455 Bennett Valley Rd, Suite C-219, Santa Rosa, CA 95404-5663 | 2009-09-30 |
| 1215260591 | Jeremy Blank | Clinical Neuropsychologist | 2455 Bennett Valley Rd, Ste B208, Santa Rosa, CA 95404-5667 | 2009-09-17 |
| 1215087697 | Traviss Family Counseling | Social Worker | 2455 Bennett Valley Rd, Suite 208b, Santa Rosa, CA 95404-5663 | 2007-01-10 |
| 1881744266 | Sandra S Traviss | Social Worker | 2455 Bennett Valley Rd, Suite 208b, Santa Rosa, CA 95404-5663 | 2007-01-10 |
| 1073660973 | Patrick A Traviss | Social Worker | 2455 Bennett Valley Rd, Suite 208b, Santa Rosa, CA 95404-5663 | 2007-01-04 |
| 1649368150 | Jain Fairfax Langston | Marriage & Family Therapist | 2455 Bennett Valley Rd, Suite B-208, Santa Rosa, CA 95404-5663 | 2006-10-10 |
| 1386674059 | Robert Benavides Jr. | Psychologist | 2455 Bennett Valley Rd, #210 C, Santa Rosa, CA 95404-5663 | 2006-07-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442217 | David Lee Dutton | Counselor | 201 S. E Street, Santa Rosa, CA 95404 | 2020-09-16 |
| 1114492162 | Jesse Earl Rathbun Jr. | Ophthalmology | 1920 Grace Dr., Santa Rosa, CA 95404 | 2018-10-05 |
| 1568958437 | Bianca Avina | Marriage & Family Therapist | 95 Montgomery Dr. #112, Santa Rosa, CA 95404 | 2018-07-03 |
| 1366940504 | New Leaf Counseling and Psychotherapy | Marriage & Family Therapist | 1030 2n Street, Suite B, Santa Rosa, CA 95404 | 2018-01-23 |
| 1659884864 | Jessica Vargas Lopez | Counselor | 3333 Chanate Road, Santa Rosa, CA 95404 | 2017-11-09 |
| 1982135992 | Gaea Keridwyn Coon | Marriage & Family Therapist | 884 Third Street, Suite D, Santa Rosa, CA 95404 | 2017-03-22 |
| 1376084699 | Empire Traditional Chinese Medicine | Acupuncturist | 1030 Second St, Santa Rosa, CA 95404 | 2017-03-20 |
| 1356888705 | Webster Surgery Center, Lp | Clinic/Center | 730 Bennett Valley Road, Santa Rosa, CA 95404 | 2017-01-24 |
| 1205295979 | Sandra Lee Krikorian | Social Worker | 101 E Street, Suite 312, Santa Rosa, CA 95404 | 2016-02-23 |
| 1396134615 | The Center for Body Oriented Psychotherapy & Wellness | Psychologist | 1626 Fourth Street, Santa Rosa, CA 95404 | 2015-01-12 |
| Find all providers in zip 95404 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922574821 | Megan Nolan | Psychologist | 4378 Bennett Valley Rd, Santa Rosa, CA 95404-6239 | 2018-10-17 |
| 1023505344 | Cross Cultural Services and Evaluations, Inc | Psychologist | 1550 Airport Blvd Ste 206, Santa Rosa, CA 95403-1095 | 2018-04-23 |
| 1053764688 | Dominic G Lucia | Psychologist | 1824 Empire Industrial Ct, Suite 'c', Santa Rosa, CA 95403-1991 | 2016-07-19 |
| 1942659024 | Anne Babin | Psychologist | 819 3rd St Ste 103, Santa Rosa, CA 95404-4546 | 2016-06-08 |
| 1649524802 | Sheila Albert | Psychologist | 4911 Perezoso Calle, Santa Rosa, CA 95409-2651 | 2012-11-08 |
| 1730443359 | Silvio Machado | Psychologist | 1626 4th St, Santa Rosa, CA 95404-4020 | 2012-06-28 |
| 1619266343 | Carla Marie Manly | Psychologist | 320 10th St Ste 303, Santa Rosa, CA 95401-5291 | 2011-04-04 |
| 1154638740 | Kimberly A Gauntlett | Psychologist | 657 Connie St, Santa Rosa, CA 95407-6267 | 2010-09-03 |
| 1063740736 | Kathleen A Kunster | Psychologist | 320 Tenth Street, Suite 205, Santa Rosa, CA 95401-9540 | 2009-11-18 |
| 1588801054 | Lisa Rohe | Psychologist | 1008 Fifth Street, Santa Rosa, CA 95404 | 2009-01-20 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95404 |
Please comment or provide details below to improve the information on DR. GARY A BLANK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.