Individual provider Active NPI

Boyka Dimitrova

  • Psychologist
  • Kentfield, CA
National Provider Identifier
1073708558
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY26932 Issued in CA
Practice address
1030 Sir Francis Drake Blvd Ste 120
Kentfield, CA 94904-1439
Phone
(415) 668-5955
NPI assigned
Sep 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY26932 CA Primary

Addresses

Primary practice location

1030 Sir Francis Drake Blvd Ste 120
Kentfield, CA 94904-1439

Mailing address

1030 Sir Francis Drake Blvd Ste 120
Kentfield, CA 94904-1439
Phone (415) 318-9066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150611000876 CA Practitioner - Clinical Psychologist 6002137320 Practice locations: Kentfield, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY26932CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1073708558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 SIR FRANCIS DRAKE BLVD STE 120",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041439",
            "telephone_number": "415-318-9066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 SIR FRANCIS DRAKE BLVD STE 120",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041439",
            "telephone_number": "415-668-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMITROVA",
        "first_name": "BOYKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-07",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY26932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kentfield, CA

Sources for this page

Verify at the official NPI Registry.