Tera Lynn Bodo, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

538369 Issued in CA

Practice address

50 Via Sonrisa
San Clemente, CA 92673-5669

Phone

(949) 366-0753

Fax

(949) 366-0753

NPI assigned

May 22, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013127042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 VIA SONRISA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926735669",
            "telephone_number": "949-366-0753",
            "fax_number": "949-366-0753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 VIA SONRISA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926735669",
            "telephone_number": "949-366-0753",
            "fax_number": "949-366-0753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODO",
        "first_name": "TERA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "538369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Black, PHARMD
• Ilene M. Blaisch, MSW, LSCW
• Kristin Blaney, MA, MFT
• Jack Holland Boatman, DDS
• Destiny Lee Bochinski, P.T., D.P.T.
• Body Mind Spirit Iop Inc
• Shauna Lynn Bogert, M.A.
• Bohica Investments LLC
• Jessica Ann Boller, BCBA
• Bone Docs Inc

• Registered Nurse in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.