Individual provider Active NPI

Yvonne Ann Boudevin, LCSW

  • Clinical Social Worker
  • Murrieta, CA
National Provider Identifier
1316093842
Registry record updated Mar 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8944 Issued in CA
Practice address
39755 Murrieta Hot Springs Rd
Suite D-160
Murrieta, CA 92563-9151
Phone
(951) 314-4552
Fax
(951) 239-0940
NPI assigned
Jan 26, 2007
Last updated
Mar 13, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 8944 CA Primary

Addresses

Primary practice location

39755 Murrieta Hot Springs Rd
Suite D-160
Murrieta, CA 92563-9151

Mailing address

40280 Rosewell CT
Temecula, CA 92591-7599
Phone (951) 314-4552

Other identifiers 2

IdentifierTypeStateIssuer
33BFA0MedicaidCA
1316093842OtherCAMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071004000753 CA Practitioner - Clinical Social Worker 0143315176 Practice locations: Murrieta, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

39755 Murrieta Hot Springs Rd
Suite D160
Murrieta, CA 92563-9113
Phone (951) 314-4552

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8944CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1316093842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40280 ROSEWELL CT",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925917599",
            "telephone_number": "951-314-4552",
            "fax_number": "951-239-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39755 MURRIETA HOT SPRINGS RD",
            "address_2": "SUITE D-160",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925639151",
            "telephone_number": "951-314-4552",
            "fax_number": "951-239-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDEVIN",
        "first_name": "YVONNE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "8944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33BFA0",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1316093842",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.