Active NPI
Jennifer Anne Boisvert, PH.D.
- Clinical Psychologist
- Long Beach, CA
National Provider Identifier
1639437544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 21459
- Practice address
- 110 W Ocean Blvd
Ste 18
Long Beach, CA 90802-4605 - Phone
- (714) 898-0362
- Fax
- (714) 893-3269
- NPI assigned
- Apr 27, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 21459 | CA | Primary |
Addresses
Primary practice location
110 W Ocean Blvd
Ste 18
Long Beach, CA 90802-4605
Mailing address
110 W Ocean Blvd
Ste 18
Long Beach, CA 90802-4605
Phone (714) 898-0362
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jun 21, 2018 through Jun 21, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21459 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associated Therapists, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychologist
- Huntington Beach, CA
- NPI 1801977319
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335484800000",
"number": "1639437544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 W OCEAN BLVD",
"address_2": "STE 18",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908024605",
"telephone_number": "714-898-0362",
"fax_number": "714-893-3269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 W OCEAN BLVD",
"address_2": "STE 18",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908024605",
"telephone_number": "714-898-0362",
"fax_number": "714-893-3269"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOISVERT",
"first_name": "JENNIFER",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-27",
"last_updated": "2012-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "21459",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.