Caroline M De Heaulme de Boutsocq

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

54808 Issued in CA

Practice address

1633 Old Bayshore Hwy Ste 145
Burlingame, CA 94010-1530

Phone

(650) 239-9075

NPI assigned

Oct 15, 2026

Last updated

Oct 15, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1792022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792022400000",
    "number": "1275439309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 S QUEBEC ST",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 OLD BAYSHORE HWY STE 145",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940101530",
            "telephone_number": "650-239-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE HEAULME DE BOUTSOCQ",
        "first_name": "CAROLINE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-15",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "54808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophia Laurel Davis, MD
• Taylor Patricia Davis
• Rachael Emily Dawson, LEP
• Kiauna Day-Smith, MS, PPS
• Mary Grace De Castro, MA
• Jenniffer De la Cruz Garrido
• Ajanta De, M.D.
• Michael H Debellis, PSY.D.
• Debra Shapiro, M.D., Inc. (Women Caring for Women)
• Victoria Deguzman

• Physical Therapy Assistant in Burlingame, CA
• Providers in Burlingame, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.