Boutique de Lingerie

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

BOUTIQUE DE LINGERIE

Practice address

650 San Benito St Ste 150
Hollister, CA 95023-3968

Phone

(831) 635-0722

NPI assigned

Oct 17, 2007

Last updated

Oct 17, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeannine Divincenzo

Title

Owner

Phone

(831) 635-0722

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1477742369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 SAN BENITO ST STE 150",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950233968",
            "telephone_number": "831-635-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 SAN BENITO ST STE 150",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950233968",
            "telephone_number": "831-635-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOUTIQUE DE LINGERIE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "DIVINCENZO",
        "authorized_official_first_name": "JEANNINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "831-635-0722"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Hollister, CA
• Providers in Hollister, CA by specialty
• Prosthetic/Orthotic Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.

Verify at the official NPI Registry.