Theresa Loreen Boen, ED.S.

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

7375736 Issued in AZ

Practice address

1925 W Road 1 N
Chino Valley, AZ 86323-6062

Phone

(303) 918-9913

NPI assigned

Jun 3, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1720602972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 W ROAD 1 N",
            "city": "CHINO VALLEY",
            "state": "AZ",
            "postal_code": "863236062",
            "telephone_number": "303-918-9913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 W ROAD 1 N",
            "city": "CHINO VALLEY",
            "state": "AZ",
            "postal_code": "863236062",
            "telephone_number": "303-918-9913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEN",
        "first_name": "THERESA",
        "middle_name": "LOREEN",
        "credential": "ED.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-03",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "CA",
            "license": "210174284",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "CO",
            "license": "376693",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "AZ",
            "license": "7375736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Faun Bailey, FNP-C
• Gerald Baldwin, PA-C
• Pete Banchuin, MD
• Ellina Rose Bastian
• Erin Benson
• Robert Houston Bowen, D.C.
• Nichole Lei Boy Swanson, PT, ATC
• Jewel Brighten, C.P.M., L.M.
• Daphne Brindle, MS CCC-SLP
• Anthony Joseph Brown, D.O.

• School Psychologist in Chino Valley, AZ
• Providers in Chino Valley, AZ by specialty
• School Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.