Staci Rios Boehle, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC36153 Issued in CA

Practice address

130 W Victoria St
Gardena, CA 90248-3523

Phone

(310) 715-2020

NPI assigned

Mar 12, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Staci Andrea Rios Former name

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": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649302837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4044 MIRALESTE DR",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902756525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W VICTORIA ST",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902483523",
            "telephone_number": "310-715-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHLE",
        "first_name": "STACI",
        "middle_name": "RIOS",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC36153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACI",
            "last_name": "RIOS",
            "middle_name": "ANDREA",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Marriage & Family Therapist in Gardena, CA
• Providers in Gardena, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.