Jeremee Michelle Bouchard, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS 24642 Issued in CA

Practice address

27955 Smyth Dr Ste 101
Valencia, CA 91355-4037

Phone

(323) 205-0730

Fax

(818) 366-6901

NPI assigned

Mar 8, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2020 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1205967429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 W EMPIRE AVE # 1050",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915043434",
            "telephone_number": "323-205-0730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27955 SMYTH DR STE 101",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913554037",
            "telephone_number": "323-205-0730",
            "fax_number": "818-366-6901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHARD",
        "first_name": "JEREMEE",
        "middle_name": "MICHELLE",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 24642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriela Bonilla
• Rylee Addison Booth
• Leisha Borja, LMFT
• Wendy Boschma, M.A. CCC/SLP
• Boston Scientific Neuromodulation Corporation
• Chase Everett Bowers
• Sheala Bowman
• Jeff Bowne, D.C.
• Boxbox Crew Inc
• William J Bozlee, RN

• Clinical Social Worker in Valencia, CA
• Providers in Valencia, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.