Provider Demographics
NPI:1154543411
Name:BLANCHET, LORRAINE D (MA MFT INTERN)
Entity type:Individual
Prefix:MS
First Name:LORRAINE
Middle Name:D
Last Name:BLANCHET
Suffix:
Gender:F
Credentials:MA MFT INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20691 CURL COURT
Mailing Address - Street 2:
Mailing Address - City:LAKEHEAD
Mailing Address - State:CA
Mailing Address - Zip Code:96051
Mailing Address - Country:US
Mailing Address - Phone:530-238-8621
Mailing Address - Fax:
Practice Address - Street 1:1515 S OREGON ST
Practice Address - Street 2:SUITE A
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097
Practice Address - Country:US
Practice Address - Phone:530-842-3455
Practice Address - Fax:530-842-7917
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical