Andrea Aylene Boardman
Individual provider Active NPI Counselor · Lompoc, CA
NPI 1063550754 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1063550754
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 117 N B St
Lompoc, CA 93436-6901 - Phone
- (805) 737-6693
- NPI assigned
- Feb 2, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
117 N B St
Lompoc, CA 93436-6901
Mailing address
117 N B St
Lompoc, CA 93436-6901
Phone (805) 737-6693
Other providers in Lompoc, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.