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FREDERICK BLUM MFT, PHD.

>> Marriage & Family Therapist >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1053506147

Individual Registrant:
 FREDERICK  BLUM MFT, PHD.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
16955 LEMON ST  HESPERIA, CA 92345-5139 US
Tel: 760-947-8223  Fax: 760-947-8225

Contact information for business:
1096 CALIMESA BLVD SUITE 207 CALIMESA, CA 92320-1552 US
Tel: 951-533-7467  Fax: --

Registration Information:
NPI: 1053506147
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y106H00000XBehavioral Health & Social Service Providers
Marriage & Family Therapist
CAMFC 23846

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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