Colette Ashley Booterbaugh

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT101810 Issued in CA

Practice address

1750 Cirby Way
Roseville, CA 95661-5520

Phone

(916) 771-6565

NPI assigned

Feb 27, 2023

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Roseville Joint Union High School District

  • Local Education Agency (LEA)
  • Roseville, CA
  • NPI 1124311592
  NPD (past)

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1417656653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 CIRBY WAY",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956615520",
            "telephone_number": "916-771-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 CIRBY WAY",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956615520",
            "telephone_number": "916-771-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTERBAUGH",
        "first_name": "COLETTE",
        "middle_name": "ASHLEY",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT101810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Bony, MD
• Jerome Davis Booker Jr., M.D.
• Gina Boomershine, PT
• Thais Carvalho Booms, DDS
• Mandie Boone, MS OTR
• Edwin Booze
• Stephen L. Borchers, MD
• Joseph Bunker Borders
• Sara Borges, MS SLP
• Graziella Borgesi, DPT

• Marriage & Family Therapist in Roseville, CA
• Providers in Roseville, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.