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

Dr. Gary A Blank, PHD

Individual provider Clinical Psychologist · NPI 1316160906

Dr. Gary A Blank, PHD is a Clinical Psychologist in Santa Rosa, California. Qualified in 1967, 59 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in California.

Years since qualifying
59
Licensed in
CA
In the registry since
2007
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

2455 Bennett Valley Rd Ste 208B
Santa Rosa, CA 95404-5663
Phone: (707) 526-2525
Fax: (707) 526-2593
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY3303 (CA)

Record details

NPI number1316160906
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedApril 11, 2007
Last updated in NPPESJuly 8, 2007
Mailing address2455 Bennett Valley Rd, Suite 208b, Santa Rosa, CA 95404-5663

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1967 (59 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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