Provider Demographics
NPI:1366202582
Name:BLOMQUIST, JENNIFER (PPS)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:BLOMQUIST
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PPS
Mailing Address - Street 1:2280 6TH ST
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-3261
Mailing Address - Country:US
Mailing Address - Phone:530-532-5848
Mailing Address - Fax:
Practice Address - Street 1:2280 6TH ST
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-3261
Practice Address - Country:US
Practice Address - Phone:530-532-5848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool