Yvette Bouphavong

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

VN711009 Issued in CA

Practice address

4411 E Kings Canyon Rd # 319
Fresno, CA 93702-3604

Phone

(559) 600-2382

NPI assigned

Mar 8, 2021

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

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

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1487249785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 W SHAW AVE STE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113229",
            "telephone_number": "559-558-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 E KINGS CANYON RD # 319",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937023604",
            "telephone_number": "559-600-2382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUPHAVONG",
        "first_name": "YVETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-08",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN711009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabella Boucher
• Jacob Robert Boucher
• Karissa Anne Bouchie, RD, LD, CDE
• Fady Boules
• Christina Bounyavong
• Dion S Bourdase
• Emily Bourdon
• Evelyn Bourgoin
• Kelli Anne Bouscher, LMFT
• Brandon Boutvyseth

• Licensed Vocational Nurse in Fresno, CA
• Providers in Fresno, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; 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.