Fady Boules

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95003306 Issued in CA

Practice address

1809 W Redlands Blvd Ste 103
Redlands, CA 92373-8054

Phone

(909) 707-6261

NPI assigned

Oct 23, 2015

Last updated

Oct 16, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Inland Psychiatric Medical Group IncGroup PAC ID 9436062312, 119 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Nurse Practitioner

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4

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

• Inland Psychiatric Medical Group, Inc.

  • Psychiatry Physician
  • Redlands, CA
  • NPI 1649217761

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Mellow Medical Inc a Professional Corporation

  • Psychiatry Physician
  • West Hollywood, CA
  • NPI 1407275886
  Medicare reassignment NPD
• Pinnacle Medical Group, Inc

  dba Optum

  • Family Medicine Physician
  • Fontana, CA
  • NPI 1376876912
  Medicare reassignment NPD
• Golden Valley Health Centers

  • Federally Qualified Health Center (FQHC)
  • Turlock, CA
  • NPI 1356445753
  Medicare reassignment
• Amal Tanagho Psychiatric Services, Inc.

  • Psychiatry Physician
  • Huntington Beach, CA
  • NPI 1023342540
  NPD
• Inland Psychiatric Medical Group Inc

  • Psychiatry Physician
  • Loma Linda, CA
  • NPI 1710535968

  Psychiatric/Mental Health

  NPD
• Inland Psychiatric Medical Group, Inc.

  • Psychiatry Physician
  • Redlands, CA
  • NPI 1336977990

  Psychiatric/Mental Health

  NPD
• Pinnacle Medical Group, Inc

  • Family Medicine Physician
  • Fontana, CA
  • NPI 1043255763
  NPD
• Cajon Medical Group, PC

  • Internal Medicine Physician
  • Temecula, CA
  • NPI 1245118082
  NPD (past)
• Pomona Valley Hospital Medical Center

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1518067586
  NPD (past)
• Raafat W. Girgis, M.D., Inc.

  • Psychiatry Physician
  • Newport Beach, CA
  • NPI 1053626630
  NPD (past)
• Scripps Health

  dba Scripps Mercy Hospital

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1659359446
  NPD (past)

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

{
    "created_epoch": "1445558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792108800000",
    "number": "1639541022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18672 FLORIDA ST STE 201C",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926486088",
            "telephone_number": "951-268-0745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 W REDLANDS BLVD STE 103",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738054",
            "telephone_number": "909-707-6261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2010 N Fine Ave # 105",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937271558",
            "country_code": "US",
            "telephone_number": "559-457-6770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 Dove St Ste 145",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "926603034",
            "country_code": "US",
            "telephone_number": "949-955-1088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18672 Florida St Ste 201C",
            "address_purpose": "LOCATION",
            "city": "Huntington Beach",
            "state": "CA",
            "postal_code": "926486088",
            "country_code": "US",
            "telephone_number": "714-916-0499",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3451 W Shaw Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937113242",
            "country_code": "US",
            "telephone_number": "559-457-6770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1880 E Washington St",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923244621",
            "country_code": "US",
            "telephone_number": "909-423-0234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3451 W Shaw Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937113242",
            "country_code": "US",
            "telephone_number": "559-457-6770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "69175 Ramon Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Cathedral City",
            "state": "CA",
            "postal_code": "922343344",
            "country_code": "US",
            "telephone_number": "760-321-6776",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55497 Van Buren St",
            "address_purpose": "LOCATION",
            "city": "Thermal",
            "state": "CA",
            "postal_code": "922749412",
            "country_code": "US",
            "telephone_number": "760-399-4526",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2002 N Fine Ave Unit 101",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937271511",
            "country_code": "US",
            "telephone_number": "951-722-0801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "302 Fresno St Ste 106",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937063641",
            "country_code": "US",
            "telephone_number": "553-457-6770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "133 W Main St",
            "address_purpose": "LOCATION",
            "city": "El Cajon",
            "state": "CA",
            "postal_code": "920203315",
            "country_code": "US",
            "telephone_number": "619-401-0404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOULES",
        "first_name": "FADY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-23",
        "last_updated": "2026-10-16",
        "certification_date": "2026-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003306",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95003306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LIC",
            "identifier": "D4304887",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theodore George Boozalis
• Fardad Borhani, DMD
• Alexandria Borjon
• Janee Brooke Both-Gragg, PHD, MFT
• Leah Fay Botimer, CPNP
• Kirsten Cathell Boulton, LCSW
• Mary Bourang, FNP
• Robert CM Bourne, M.D.
• Jana K Boyd, JANA BOYD, PHD
• Vicky Reyes Boykins, LMFT

• Psychiatric/Mental Health Nurse Practitioner in Redlands, CA
• Providers in Redlands, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.