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1730801184
BLAYKE GABRIELLA ROBERTS
SAN DIEGO, CA
NPI
1730801184
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 13803)
Enumeration Date
2022-09-13
Last Update Date
2023-03-13
Business Address
BLAYKE GABRIELLA ROBERTS SUDRC
3340 KEMPER ST STE 105
SAN DIEGO, CA 92110-4907
Phone number: 619-523-8121
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Mailing Address
BLAYKE GABRIELLA ROBERTS SUDRC
823 GATEWAY CENTER WAY
SAN DIEGO, CA 92102-4541
Phone number: 619-515-2300
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