Active NPI
Amy Marie Van Boven, PHD LCSW CADC ACSW
- Psychologist
- Sacramento, CA
National Provider Identifier
1174675573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY21228
- Practice address
- 8912 Volunteer LN
Sacramento, CA 95826-3224 - Phone
- (916) 344-0199
- Fax
- (916) 344-0196
- NPI assigned
- Jan 17, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY21228 | CA | Primary |
Addresses
Primary practice location
8912 Volunteer LN
Sacramento, CA 95826-3224
Mailing address
8912 Volunteer LN
Sacramento, CA 95826-3224
Phone (916) 344-0199
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY21228 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216771200000",
"number": "1174675573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8912 VOLUNTEER LN",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958263224",
"telephone_number": "916-344-0199",
"fax_number": "916-344-0196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8912 VOLUNTEER LN",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958263224",
"telephone_number": "916-344-0199",
"fax_number": "916-344-0196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN BOVEN",
"first_name": "AMY",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "PHD LCSW CADC ACSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-17",
"last_updated": "2008-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY21228",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.