Provider Demographics
NPI:1457174153
Name:BLAKELEY, SHEILA LOUISE
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:LOUISE
Last Name:BLAKELEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11280 VISTA SORRENTO PKWY # P306
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-7637
Mailing Address - Country:US
Mailing Address - Phone:760-612-6924
Mailing Address - Fax:
Practice Address - Street 1:11280 VISTA SORRENTO PKWY # P306
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-7637
Practice Address - Country:US
Practice Address - Phone:760-612-6924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-02
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide