QUINTIN BLAYLOCK (NPI# 1194349498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194349498 |
| Entity Type | Individual |
| Full Name | QUINTIN BLAYLOCK |
| Practice Address |
239 W 9th St Upland CA 91786-5979 |
| Practice Telephone | 9099816121 |
| Mailing Telephone | 9099816121 |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2020-07-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
R1326201018 | CA | Behavioral Health & Social Service Providers |
| Street Address |
239 W 9TH ST |
| City | UPLAND |
| State | CA |
| Zip Code | 91786-5979 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659662351 | G & C Swan Inc | Substance Abuse Rehabilitation Facility | 239 W 9th St, Upland, CA 91786-5979 | 2011-04-28 |
| 1598366304 | Theresa Smith | Counselor | 239 W 9th St, Upland, CA 91786-5979 | 2020-11-06 |
| 1356941439 | Brianna Levy | Licensed Vocational Nurse | 239 W 9th St, Upland, CA 91786-5979 | 2020-10-28 |
| 1225651755 | John Morgan | Counselor | 239 W 9th St, Upland, CA 91786-5979 | 2020-05-19 |
| 1780217901 | James Lloyd Merkel | Counselor | 239 W 9th St, Upland, CA 91786-5979 | 2020-02-17 |
| 1336772870 | Andrew Freeman | Counselor | 239 W 9th St, Upland, CA 91786-5979 | 2020-02-12 |
| 1861025322 | Gerald Jeronimo Velarde | Counselor | 239 W 9th St, Upland, CA 91786-5979 | 2020-02-12 |
| 1437781093 | Krystal Rasmussen | Counselor | 239 W 9th St, Upland, CA 91786-5979 | 2020-02-11 |
| 1033741624 | Michael Thompson | Counselor | 239 W 9th St, Upland, CA 91786-5979 | 2020-02-11 |
| 1700418837 | Andrew Wildasinn | Counselor | 239 W 9th St, Upland, CA 91786-5979 | 2020-02-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366093254 | California Clinics, Inc | Physical Medicine & Rehabilitation | 818 N Mountain Ave Ste 102, Upland, CA 91786 | 2019-09-23 |
| 1699231621 | Lynn Keitz | Nurse Practitioner | 360 East 7th Street, Suite D, Upland, CA 91786 | 2019-02-14 |
| 1003386608 | Devin A Lockett | Counselor | 916 N, Mountain Ave. Suite D-1, Upland, CA 91786 | 2018-11-27 |
| 1265900096 | Right Ride | Driver | 1023 West Arrow Hwy Apt A, Upland, CA 91786 | 2018-11-09 |
| 1689142069 | Mike Sedat Safi | Driver | 1023 W Arrow Hwy, Apt A, Upland, CA 91786 | 2018-11-05 |
| 1902373640 | Barsoum Dental | Dentist | 258 E. 9th Street, Upland, CA 91786 | 2018-10-31 |
| 1346736600 | Jennifer Lynn Henshaw | Counselor | Rosewood Counseling Center, 288 W 9th Street, Upland, CA 91786 | 2018-07-10 |
| 1972099521 | Sadeg Aldolaim | Nurse Practitioner | 2086 W Arrow Route, Apt 824, Upland, CA 91786 | 2018-07-06 |
| 1831607332 | Sandra Sun | Pharmacist | 1445 E. Foothill Blvd., Upland, CA 91786 | 2018-01-18 |
| 1841713625 | Dynamic Performance Physical Therapy Inc | Clinic/Center | 2377 W. Foothill Blvd, Ste 20, Upland, CA 91786 | 2017-07-24 |
| Find all providers in zip 91786 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467059725 | Nicholas Howard Munoz | Counselor | 934 N Mountain Ave Ste C-d, Upland, CA 91786-3659 | 2020-10-08 |
| 1437625969 | Melissa Jean Hacker | Counselor | 934 N Mountain Ave Ste A, Upland, CA 91786-3659 | 2018-10-23 |
| 1356887152 | Erica Roxanne Caudillo | Counselor | 167 N 3rd Ave Ste N, Upland, CA 91786-6052 | 2017-01-17 |
| 1255729422 | Alexander Murray | Counselor | 1260 E. Arrow Hwy Bldg. E, Upland, CA 91786 | 2014-12-22 |
| 1477875433 | Sandra I. Romero | Counselor | 916 N. Mountain Ave., Suite A, Upland, CA 91786 | 2010-02-18 |
| 1467788315 | Becky Baker | Counselor | 916 N Mountain Ave Ste A, Upland, CA 91786-3658 | 2009-10-28 |
| 1669697322 | Robert Andrew Gallegos | Counselor | 1260 E Arrow Hwy Bldg B, Upland, CA 91786-4996 | 2007-04-16 |
| 1831222652 | Susan Evette Otero | Counselor | 916 N Mountain Ave, Suite A, Upland, CA 91786-3697 | 2007-03-13 |
| 1245387687 | Janice Kay Degrande | Counselor | 1260 E Arrow Hwy Bldg C, Upland, CA 91786-4987 | 2007-01-05 |
| 1598366304 | Theresa Smith | Counselor | 239 W 9th St, Upland, CA 91786-5979 | 2020-11-06 |
| Find all providers in UPLAND | ||||
Please comment or provide details below to improve the information on QUINTIN BLAYLOCK.
| 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.