Individual provider Active NPI

Ruth M Boisseree, NP

  • Obstetrics & Gynecology Nurse Practitioner
  • Templeton, CA
National Provider Identifier
1407054414
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
17321 Issued in CA
Practice address
350 Posada Lane
Suite 202
Templeton, CA 93465-4060
Phone
(805) 434-5497
Fax
(805) 434-0917
NPI assigned
Jul 11, 2007
Last updated
Sep 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 17321 CA Primary

Addresses

Primary practice location

350 Posada Lane
Suite 202
Templeton, CA 93465-4060

Mailing address

117 West Bunny Avenue
Santa Maria, CA 93458-2805
Phone (805) 739-3474

Other identifiers 1

IdentifierTypeStateIssuer
CB221314OtherCAMEDICARE ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
17321CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Central Coast Health Centers Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1407054414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 WEST BUNNY AVENUE",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934582805",
            "telephone_number": "805-739-3474",
            "fax_number": "805-739-3982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 POSADA LANE",
            "address_2": "SUITE 202",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934654060",
            "telephone_number": "805-434-5497",
            "fax_number": "805-434-0917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOISSEREE",
        "first_name": "RUTH",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CA",
            "license": "17321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "CB221314",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Templeton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.