Individual provider Active NPI

Sandra Ellen Boshears, DC

  • Chiropractor
  • Yucaipa, CA
National Provider Identifier
1790701407
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC0270160 Issued in CA
Practice address
35191 Yucaipa Blvd
Yucaipa, CA 92399
Phone
(909) 790-5005
Fax
(909) 790-5009
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC27016 CA
Chiropractor 111N00000X DC0270160 CA Primary

Addresses

Primary practice location

35191 Yucaipa Blvd
Yucaipa, CA 92399

Mailing address

35191 Yucaipa Blvd
Yucaipa, CA 92399
Phone (909) 790-5005

Other identifiers 1

IdentifierTypeStateIssuer
GDC000570MedicaidCA

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC0270160CAMDChiropractor
DC27016CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Heskett Family Chiropractic Chiropractor PastSince Nov 21, 2021 Accepting new patients
California Chiropractic Chiropractor PastSince Oct 1, 2006 Accepting new patients
California Chiropractic Boshears, Inc. Chiropractor PastSince Dec 1, 2007 Accepting new patients

Organizations & group practices 3

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205884800000",
    "number": "1790701407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35191 YUCAIPA BLVD",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "92399",
            "telephone_number": "909-790-5005",
            "fax_number": "909-790-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35191 YUCAIPA BLVD",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "92399",
            "telephone_number": "909-790-5005",
            "fax_number": "909-790-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSHEARS",
        "first_name": "SANDRA",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2008-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC27016",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC0270160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GDC000570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucaipa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.

Verify at the official NPI Registry.