Heather Boucher
Individual provider Active NPI Speech-Language Pathologist · Los Angeles, CA
NPI 1376918243 · NPPES record last updated Dec 3, 2015
Key facts
- NPI
- 1376918243
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 10019 (CA)
- Practice address
- 11900 W Olympic Blvd
410
Los Angeles, CA 90064-1151 - Phone
- (424) 371-9680
- NPI assigned
- Dec 3, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 10019 | CA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 10019 | CA | Yes |
Addresses
Primary practice location
11900 W Olympic Blvd
410
Los Angeles, CA 90064-1151
Mailing address
11900 W Olympic Blvd
410
Los Angeles, CA 90064-1151
Other providers in Los Angeles, CA
- Tin C. Botzler
- Michael Bouaziz
- Cynthia Boubion
- Houda Boucekkine
- Marcel Bouchard
- Jane Kim Boucher
- Michael Lewis Boucher
- Raymond Bouchereau Jr.
- Alex Boudaie
- Doris Boudaie
All providers in Los Angeles, CA · Speech-Language Pathologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2015. 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.