Individual provider · Type 1 NPI

Tanisha Sharee Blaze

Peer Specialist · Fontana, CA

NPI number 1104486471 Active

Practice location

14677 Merrill Ave
Fontana, CA 92335

Call (951) 643-2340 Map

Mailing address

23341 Hemlock Ave Apt 13
Moreno Valley, CA 92557-7003

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000XNone listed

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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About NPI 1104486471

Tanisha Sharee Blaze's National Provider Identifier is 1104486471, issued on Jun 18, 2019. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Fontana, CA. The record was last updated on Jun 18, 2019.