Active NPI
Travis Boone
- Technician
- Trabuco Canyon, CA
National Provider Identifier
1467021311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Technician
- License
- RT1435360326
- Practice address
- 20331 Flanagan Rd
Trabuco Canyon, CA 92679 - Phone
- (818) 582-8832
- Fax
- (818) 582-8836
- NPI assigned
- Jun 23, 2021
- Last updated
- Apr 7, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Technician | 374700000X | RT1435360326 | CA | Primary |
Addresses
Primary practice location
20331 Flanagan Rd
Trabuco Canyon, CA 92679
Mailing address
32310 Riverside Dr SPC 21
Lake Elsinore, CA 92530-7884
Phone (626) 361-3840
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RT1435360326 | CA | MD | Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Teen Project, Inc. | 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.
-
dba Vera's Sanctuary
- Children's Substance Abuse Rehabilitation Facility
- Trabuco Canyon, CA
- NPI 1609345743
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775520000000",
"number": "1467021311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32310 RIVERSIDE DR SPC 21",
"city": "LAKE ELSINORE",
"state": "CA",
"postal_code": "925307884",
"telephone_number": "626-361-3840",
"fax_number": "999-999-9999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20331 FLANAGAN RD",
"city": "TRABUCO CANYON",
"state": "CA",
"postal_code": "92679",
"telephone_number": "818-582-8832",
"fax_number": "818-582-8836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOONE",
"first_name": "TRAVIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-23",
"last_updated": "2026-04-07",
"certification_date": "2026-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "374700000X",
"taxonomy_group": "",
"desc": "Technician",
"state": "CA",
"license": "RT1435360326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Trabuco Canyon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.