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

Shaun Roland Blake, DPT

Individual provider Physical Therapist · NPI 1255619490

Shaun Roland Blake, DPT is a Physical Therapist in Private Practice in Encinitas, California. Qualified in 2008, 18 years ago. Practices with Avera McKennan, a 962-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
18
Licensed in
CA
In the registry since
2011
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

332 Santa Fe Dr Ste 120
Encinitas, CA 92024-5143
Phone: (760) 942-4400
Fax: (760) 942-4450
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 38074 (CA)

Record details

NPI number1255619490
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedJuly 21, 2011
Last updated in NPPESJuly 21, 2011

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Avera McKennan — 962 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Encinitas