Active NPI
William Paul Boehm, PHD
- Psychologist
- Irvine, CA
National Provider Identifier
1770730293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY11987
- Practice address
- 4199 Campus Drive
Suite 550
Irvine, CA 92612 - Phone
- (949) 509-6554
- Fax
- (949) 509-6599
- NPI assigned
- Aug 27, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY11987 | CA | Primary |
Addresses
Primary practice location
4199 Campus Drive
Suite 550
Irvine, CA 92612
Mailing address
3611 Motor Avenue
Suite 240
Los Angeles, CA 90034
Phone (310) 837-2444
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY11987 | CA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesis Psychology Group, 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.
-
- Cognitive & Behavioral Psychologist
- Los Angeles, CA
- NPI 1245789940
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219795200000",
"number": "1770730293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3611 MOTOR AVENUE",
"address_2": "SUITE 240",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90034",
"telephone_number": "310-837-2444",
"fax_number": "310-837-5332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4199 CAMPUS DRIVE",
"address_2": "SUITE 550",
"city": "IRVINE",
"state": "CA",
"postal_code": "92612",
"telephone_number": "949-509-6554",
"fax_number": "949-509-6599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOEHM",
"first_name": "WILLIAM",
"middle_name": "PAUL",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-27",
"last_updated": "2008-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY11987",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.