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

Shantelle Denise Blackburn

Individual provider Mental Health Counselor · NPI 1164192886

Shantelle Denise Blackburn is a Mental Health Counselor in San Jose, California. Licensed in California. Registered with an NPI since 2021.

Licensed in
CA
In the registry since
2021
Specialties on file
2

Practice location Address checks out

645 Wool Creek Dr
San Jose, CA 95112-2617
Phone: (408) 283-6000
Show map & directions

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

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 114520 (CA)
Mental Health Counselor Taxonomy 101YM0800X · Licence 114520 (CA)

Record details

NPI number1164192886
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 14, 2021
Last updated in NPPESSeptember 3, 2024
Certification dateSeptember 3, 2024

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