Individual ProviderEylin Margarita BlakeMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address1421 Guerneville Rd, Santa Rosa, CA 95403-7220(707) 576-7700PECOS EnrollmentBased on the most recent information from CMS, provider Eylin Margarita Blake does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1124631494Provider TypeIndividualFull NameBlake, Eylin MargaritaCredentialAMFTGenderFemaleSole ProprietorNoEnumeration Date8/26/2020Last Updated8/26/2020Contact InformationPractice LocationPractice Address1421 Guerneville Rd, Santa Rosa, CA 95403-7220Phone(707) 576-7700FaxUnlisted FaxMailing LocationMailing Address1421 Guerneville Rd Ste 218, Santa Rosa, CA 95403-7255Phone(707) 576-7700FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicense120639CaliforniaCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense8203California