1. Home
  2. Directory
  3. California
  4. Fontana
  5. Peer Specialist
  6. NPI Profile

TANISHA SHAREE BLAZE
NPI 1104486471
Peer Specialist in Fontana, CA

Active since June 18, 2019
14677 MERRILL AVE, FONTANA, CA 92335(951) 643-2340 Get Directions Write a Review

NPPES record last updated: June 18, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Tanisha Sharee Blaze NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TANISHA SHAREE BLAZE (NPI 1104486471) is an individual peer specialist in Fontana, California and active in the NPI registry since June 2019.

NPPES Registry Identity

NPI1104486471
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameTANISHA SHAREE BLAZE
Location Address14677 MERRILL AVEFontana, CA 92335
Mailing Address23341 Hemlock Ave Apt 13Moreno Valley, CA 92557-7003 · (951) 419-2317
Phone(951) 643-2340
Sole ProprietorNo
Enumeration DateJune 18, 2019
✔ NPI 1104486471 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
14677 MERRILL AVE, Fontana, CA 92335
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CELINA CONCEPCION BENAVIDES LPT
Licensed Psychiatric Technician
14677 MERRILL AVE
FONTANA, CA 92335
San Bernardino County (951) 643-2340
KELLY ANN JIMENEZ
Social Worker (Clinical)
14677 MERRILL AVE
FONTANA, CA 92335
San Bernardino County (951) 643-2340
ZULEMA ZELENE VELAZQUEZ MA
Marriage & Family Therapist
14677 MERRILL AVE
FONTANA, CA 92335
San Bernardino County (951) 643-2340
SARA MAUL
Licensed Vocational Nurse
14677 MERRILL AVE
FONTANA, CA 92335
San Bernardino County (951) 643-2340
GRACE AVILA
Counselor
14677 MERRILL AVE
FONTANA, CA 92335
San Bernardino County (951) 643-2340
MATTHEW ALLAN BERRY
Licensed Psychiatric Technician
14677 MERRILL AVE
FONTANA, CA 92335
San Bernardino County (951) 643-2335
ALEXIS URIEL TOVAR
Social Worker
14677 MERRILL AVE
FONTANA, CA 92335
San Bernardino County (909) 643-2340
JACQUELINE NANCY CUEVAS
Licensed Vocational Nurse
14677 MERRILL AVE
FONTANA, CA 92335
San Bernardino County (951) 643-2143

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tanisha Blaze's NPI number?

The NPI number for Tanisha Blaze is 1104486471. It was assigned to this individual provider in the NPPES registry on June 18, 2019.

Where is Tanisha Blaze located?

Tanisha Blaze practices at 14677 Merrill Ave, Fontana, CA 92335. The listed phone number is (951) 643-2340.

What is Tanisha Blaze's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Tanisha Blaze was last updated on June 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.