MR. JAMES L BLAYLOCK (NPI# 1770102238) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770102238 |
| Entity Type | Individual |
| Full Name | MR. JAMES L BLAYLOCK |
| Credential | LPT-LMHW |
| Practice Address |
300 E 15th St Merced CA 95341-6217 |
| Mailing Address |
1200 Mission St Madera CA 93638-2231 |
| Practice Telephone | 2093816879 |
| Practice Fax Number | 2097253775 |
| Mailing Telephone | 5596233582 |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-04-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 167G00000X | Licensed Psychiatric Technician | 35805 | CA | Nursing Service Providers |
| Street Address |
300 E 15TH ST |
| City | MERCED |
| State | CA |
| Zip Code | 95341-6217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831247287 | Elizabeth Ann Freitas | Social Worker | 300 E 15th St, Merced, CA 95340-6217 | 2007-01-08 |
| 1659984805 | Gisselle Alexandria Aguilar | Licensed Vocational Nurse | 300 E 15th St, Merced, CA 95341-6217 | 2020-08-27 |
| 1861005480 | Debora Yvonne Franklin | Licensed Vocational Nurse | 300 E 15th St, Merced, CA 95341-6217 | 2020-08-24 |
| 1558996504 | Lacey Nicole Recinos | Technician | 300 E 15th St, Merced, CA 95341-6217 | 2020-03-10 |
| 1679133557 | Eli Sachse | Registered Nurse | 300 E 15th St, Merced, CA 95341-6217 | 2019-06-13 |
| 1770040131 | Leticia Davis | Licensed Vocational Nurse | 300 E 15th St, Merced, CA 95341-6217 | 2019-02-21 |
| 1750876777 | Kimberly Sheree Sanchez | Social Worker | 300 E 15th St, Merced, CA 95341-6217 | 2018-06-22 |
| 1992295679 | Jenna Vanderbeek | Counselor | 300 E 15th St, Merced, CA 95341-6217 | 2018-05-17 |
| 1568968550 | Amanda Mello | Licensed Vocational Nurse | 300 E 15th St, Merced, CA 95341-6217 | 2018-03-30 |
| 1033618020 | Benjamin Michael Duenas | Licensed Vocational Nurse | 300 E 15th St, Merced, CA 95341-6217 | 2018-02-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255942520 | Samantha Canal | Counselor | 300 E 13th St Suite C, Merced, CA 95341 | 2020-08-11 |
| 1043874100 | Phyllis A Patterson | Peer Specialist | 490 E 13th Street, Merced, CA 95341 | 2019-04-24 |
| 1093209488 | Cierra Nicole Sweet | Case Manager/Care Coordinator | 490 E 13th St, Merced, CA 95341 | 2018-06-19 |
| 1528444148 | Mirian Cardenas | Counselor | 301 E 13th St Ste D, Merced, CA 95341 | 2015-08-05 |
| 1962839290 | Jessica Perez | Counselor | 480 East 13th Street, Building, Merced, CA 95341 | 2013-10-01 |
| 1235417171 | Mayla T Carlos | Physician Assistant | 847 W. Childs Ave., Merced, CA 95341 | 2011-07-26 |
| 1588951883 | Altia N Johnson | Registered Nurse | 260 E 15th Street, Merced, CA 95341 | 2011-07-07 |
| 1598061657 | County of Merced | Clinic/Center | 490 E. 13th Street, Merced, CA 95341 | 2011-02-07 |
| 1275710741 | Kathryn Renee Rodriguez | Social Worker | 2777 N Highway 59, Merced County Adult Services, Merced, CA 95341 | 2008-01-28 |
| 1700060324 | Irene Miranda-henson | Registered Nurse | 797 West Childs Avenue, Merced, CA 95341 | 2007-12-18 |
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| Taxonomy Code | 167G00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Psychiatric Technician |
| An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750994380 | Betsy A Peralta | Licensed Psychiatric Technician | 300 E 15th St Ste C, Merced, CA 95341-6217 | 2020-08-24 |
| 1073168951 | Tanya Pavela Eliapo | Licensed Psychiatric Technician | 301 E 13th St, Merced, CA 95341-6211 | 2019-08-07 |
| 1831663046 | Delaney P Delgado | Licensed Psychiatric Technician | 300 E 15th St Ste B, Merced, CA 95341-6217 | 2019-01-22 |
| 1700300050 | Jess Reyes Valenzuela | Licensed Psychiatric Technician | 300 E 15th St Ste B, Merced, CA 95341-6217 | 2017-07-28 |
| 1225424211 | Tony Jackson | Licensed Psychiatric Technician | 300 E 15th St, Merced, CA 95341-6217 | 2015-04-07 |
| 1659763142 | Joshua Mcwealth | Licensed Psychiatric Technician | 300 E 15th St, Merced, CA 95341-6217 | 2015-02-20 |
| 1871936310 | Claudia Victoria Garcia Flores | Licensed Psychiatric Technician | 300 E 15th St, Merced, CA 95341-6217 | 2013-04-15 |
| 1346586328 | Jay S Ybanez | Licensed Psychiatric Technician | 300 E 15th St, Merced, CA 95341-6217 | 2012-12-20 |
| 1114274461 | Andrea Preciado | Licensed Psychiatric Technician | 300 E 15th St, Merced, CA 95341-6217 | 2012-08-06 |
| 1578698064 | Martin N Miller | Licensed Psychiatric Technician | 300 E 15th St, Merced, CA 95340-6217 | 2007-02-23 |
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| 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.