Nicole Bouchard

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

RI-G0905181439 Issued in CA

Practice address

429 Speers Rd
Santa Rosa, CA 95409-3123

Phone

(707) 571-2215

NPI assigned

Aug 26, 2009

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• R House, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Santa Rosa, CA
  • NPI 1760516702
  NPD (past)

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251244800000",
    "number": "1033342928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2587",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954050587",
            "telephone_number": "707-571-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 SPEERS RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954093123",
            "telephone_number": "707-571-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHARD",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-26",
        "last_updated": "2009-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "RI-G0905181439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vaya Borton
• Erica Joeverley Bosque, LCSW
• Roy Lucas Bostick
• Sean Thomas Bosworth
• Brendan Bottari, M.D.
• Marla Bourgea
• Aimee Jean Bourke
• Amanda Kay Bourke, BA
• Karen Frances Bowden
• Stacy Bowdish, MA

• Addiction (Substance Use Disorder) Counselor in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2009; 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.