Jocelyn Constance Bouchard, NMD
Individual provider Active NPI Naturopath · Avondale, AZ
NPI 1255003802 · NPPES record last updated Nov 29, 2023
Key facts
- NPI
- 1255003802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Naturopath 175F00000X
- License
- 21-1662 (AZ)
- Practice address
- 1350 N 117TH Ave Unit 19
Avondale, AZ 85392-2202 - Phone
- (520) 344-0308
- NPI assigned
- Oct 1, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21-1662 | AZ | MD | Naturopath |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centro de Salud Familiar | Past | Accepting new patients | |
| Prototype Health, Inc | Naturopath | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | 21-1662 | AZ | Yes |
Addresses
Primary practice location
1350 N 117TH Ave Unit 19
Avondale, AZ 85392-2202
Mailing address
1350 N 117TH Ave Unit 19
Avondale, AZ 85392-2202
Phone (502) 344-0308
Other practice location 1
1039 N Country Club Dr
Mesa, AZ 85201-3300
Phone (480) 590-5212
Other practice location 2
2121 W Indian School Rd
Phoenix, AZ 85015-4908
Phone (602) 241-9105
Other providers in Avondale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2023. 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.