Jeffery Boots
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Stanton, CA
NPI 1497100069 · NPPES record last updated Mar 23, 2022
Key facts
- NPI
- 1497100069
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 9264 (CA)
- Practice address
- 10751 Dale Ave
Stanton, CA 90680-2604 - Phone
- (714) 821-5311
- NPI assigned
- May 2, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Pacific Med-Corp | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 9264 | CA | Yes |
Addresses
Primary practice location
10751 Dale Ave
Stanton, CA 90680-2604
Mailing address
10751 Dale Ave
Stanton, CA 90680-2604
Phone (714) 821-5311
Other providers in Stanton, CA
- Kaitlyn Betancourt
- Big Vine Home Health Services, Inc
- Michael Vincent Bigay
- Kamaliah Binti Jalalonmuhali
- Thomas Michael Boone
- Morgan Leigh Boyer
- Rachel Laura Bradley
- Sam Brandel
- Glen Brinagh
- Melissa Kiyo Broberg
All providers in Stanton, CA · Addiction (Substance Use Disorder) Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.