Charles Boston, SUDCC III

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

00700 Issued in NV

Practice address

955 E Thompson Blvd
Ventura, CA 93001-3008

Phone

(805) 641-9100

Fax

(805) 641-2040

NPI assigned

Apr 14, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1205280344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 E THOMPSON BLVD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930013008",
            "telephone_number": "805-641-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 E THOMPSON BLVD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930013008",
            "telephone_number": "805-641-9100",
            "fax_number": "805-641-2040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1755 Sullivan Ln",
            "address_purpose": "LOCATION",
            "city": "Sparks",
            "state": "NV",
            "postal_code": "894312815",
            "country_code": "US",
            "telephone_number": "775-355-7734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSTON",
        "first_name": "CHARLES",
        "credential": "SUDCC III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-14",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "00700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922056415",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisette Borg, MFT
• James Keller Borgeson, LMFT
• Yvonne R Borja
• Briana Nicole Boskovich
• Rebeca Sarahi Bosques, DO
• Boswell Mtu
• Jacqueline B Boswell, OTR
• Charlotte Bourdillon, MD
• Nicole M Boutte
• Claire Bova

• Addiction (Substance Use Disorder) Counselor in Ventura, CA
• Providers in Ventura, 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 Jun 3, 2021; 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.