Individual provider Active NPI

Mariel Bosserman, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Eureka, CA
National Provider Identifier
1548610934
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95003971 Issued in CA
Practice address
100 H St Ste 212
Eureka, CA 95501-0481
Phone
(707) 390-0393
Fax
(707) 440-1524
NPI assigned
Jun 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 95003971 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95003971 CA Primary

Addresses

Primary practice location

100 H St Ste 212
Eureka, CA 95501-0481

Mailing address

100 H St Ste 212
Eureka, CA 95501-0481
Phone (707) 390-0393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191127000858 CA Practitioner - Nurse Practitioner 7517390834 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95003971CAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Community Health Centers Current Accepting new patients
Open Door Community Health Centers CurrentSince Aug 4, 2019 Accepting new patients
Humboldt Counseling Connection CurrentSince Mar 20, 2025 Accepting new patients
Open Door Community Health Centers CurrentSince Aug 4, 2019 Accepting new patients
Open Door Community Health Centers Current Accepting new patients
Open Door Community Health Centers Current Accepting new patients

Locations

785 18th St
Arcata, CA 95521
Phone (707) 822-2481

1275 8th St
Arcata, CA 95521

770 10th St
Arcata, CA 95521
Phone (707) 826-8610

550 E Washington Blvd
Crescent City, CA 95531
Phone (707) 465-4636

2200 Tydd St
Eureka, CA 95501
Phone (707) 269-7051

123 F St
Ste F
Eureka, CA 95501
Phone (707) 268-8007

310 F St
Eureka, CA 95501
Phone (707) 390-0393

1644 Central Ave
McKinleyville, CA 95519
Phone (707) 839-3068

Interoperability endpoints

  • Direct secure messaging: mariel.bossermanrnp.p1@direct.plannedparenthoodla.nextgenshare.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1548610934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 H ST STE 212",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955010481",
            "telephone_number": "707-390-0393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 H ST STE 212",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955010481",
            "telephone_number": "707-390-0393",
            "fax_number": "707-440-1524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSSERMAN",
        "first_name": "MARIEL",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-15",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95003971",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95003971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.