Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blake Vincent Civello

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1801724406

Blake Vincent Civello is a Student in an Organized Health Care Education/Training Program in LA Jolla, California. Registered with an NPI since 2026.

In the registry since
2026

Practice location Address checks out

10666 N Torrey Pines Rd
LA Jolla, CA 92037-1027
Phone: (858) 554-3200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1801724406
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 12, 2026
Last updated in NPPESMay 12, 2026
Certification dateMay 12, 2026
Mailing address10790 Rancho Bernardo Rd., Mail Drop 4s-305, San Diego, CA 92127-5705

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