Individual provider Active NPI

Elizabeth Boman

  • Psychiatric/Mental Health Nurse Practitioner
  • Cherryland, CA
National Provider Identifier
1649783135
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95039796 Issued in CA
Practice address
21297 Foothill Blvd Ste 203
Cherryland, CA 94541-1554
Phone
(510) 317-1444
NPI assigned
Nov 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95039796 CA Primary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X 95131322 CA

Addresses

Primary practice location

21297 Foothill Blvd Ste 203
Cherryland, CA 94541-1554

Mailing address

21297 Foothill Blvd Ste 203
Cherryland, CA 94541-1554
Phone (415) 636-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95131322CAMDChild & Adolescent Psychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Exxceed Wellness, Inc. PastSince Feb 3, 2026 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.

NPI Registry JSON

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1649783135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21297 FOOTHILL BLVD STE 203",
            "city": "CHERRYLAND",
            "state": "CA",
            "postal_code": "945411554",
            "telephone_number": "415-636-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21297 FOOTHILL BLVD STE 203",
            "city": "CHERRYLAND",
            "state": "CA",
            "postal_code": "945411554",
            "telephone_number": "510-317-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMAN",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-07",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95039796",
            "primary": true
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "CA",
            "license": "95131322",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherryland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; 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.