Active NPI
Elisabeth Boucher
- Rehabilitation Practitioner
- Commerce, CA
National Provider Identifier
1467634071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 6055 E Washington Blvd
Suite 900
Commerce, CA 90040-2418 - Phone
- (323) 346-0960
- Fax
- (323) 346-0966
- NPI assigned
- Dec 5, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | Primary |
Addresses
Primary practice location
6055 E Washington Blvd
Suite 900
Commerce, CA 90040-2418
Mailing address
13603 Marina Pointe Dr
D315
Marina del Rey, CA 90292-5583
Phone (310) 396-4852
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196812800000",
"number": "1467634071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13603 MARINA POINTE DR",
"address_2": "D315",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902925583",
"telephone_number": "310-396-4852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6055 E WASHINGTON BLVD",
"address_2": "SUITE 900",
"city": "COMMERCE",
"state": "CA",
"postal_code": "900402418",
"telephone_number": "323-346-0960",
"fax_number": "323-346-0966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUCHER",
"first_name": "ELISABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-05",
"last_updated": "2007-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Commerce, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.