Courtney Boatman, LMFT 93417

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

93417 Issued in CA

Practice address

2991 Kalmia St
San Diego, CA 92104-5414

Phone

(918) 231-0359

NPI assigned

Jan 19, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1295395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1831494079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2991 KALMIA ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921045414",
            "telephone_number": "918-231-0359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2991 KALMIA ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921045414",
            "telephone_number": "918-231-0359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOATMAN",
        "first_name": "COURTNEY",
        "credential": "LMFT 93417",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-19",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "93417",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blvd Centers, Inc
• Charles Boamah, RPH
• Lynelle M. Boamah, MD
• Ebone Kay Board, NONE
• Kendra Boardingham
• Joy Lynn Boatman, PSY.D.
• Christine M Boatright, M.D.
• Renato Gianfranco Bobadilla Leon, MD
• Estela Bobadilla, IMF
• Daria Lynn Bobbin, LMFT

• All providers in San Diego, CA
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.