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

Mierra Mary Blake

Individual provider Rehabilitation Practitioner · NPI 1053003939

Mierra Mary Blake is a Rehabilitation Practitioner in Sacramento, California. Licensed in California. Registered with an NPI since 2023.

Licensed in
CA
In the registry since
2023
Specialties on file
2

Practice location Address checks out

7171 Bowling Dr
Sacramento, CA 95823-2034
Phone: (707) 740-2420
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X (CA)
Rehabilitation Practitioner Taxonomy 225400000X

Record details

NPI number1053003939
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 22, 2023
Last updated in NPPESAugust 3, 2026
Certification dateAugust 3, 2026

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