Search › California › 1041C0700X
Travis Blair, ACSW
NPI 1043762321 · on the registry since 2016 · sole proprietor
Practice
- Address
- 11600 Eldridge Ave
Lake View Terrace, CA 91342 - Phone
- (818) 686-3000
- Organisation at this address
- Phoenix House Foundation
Phoenix Houses Of Los Angeles, Inc.
Phoenix Houses Of Los Angeles, Inc.
Phoenix House California - Lake View TerraceInferred from a shared address, not stated in the registry. - Clinicians at this address
- 161
Additional practice sites
- 14202 20th Ave, Flushing, NY
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 101YA0400X
390200000X - Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-04-22
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California