Blake Steven Bouldin

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95038915 Issued in CA

Practice address

28141 Branch Rd
Castaic, CA 91384-3002

Phone

(818) 731-8759

NPI assigned

Mar 13, 2026

Last updated

Mar 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Senior Doc Integrated Med PCGroup PAC ID 3375990286, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Senior Doc Integrated Med, PC

  • Family Medicine Physician
  • Santa Ana, CA
  • NPI 1396526026
  Medicare reassignment Care Compare group
• Access Healthcare Associates a Medical Corporation

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1013109834
  Medicare reassignment

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

{
    "created_epoch": "1773360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1841147337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28141 BRANCH RD",
            "city": "CASTAIC",
            "state": "CA",
            "postal_code": "913843002",
            "telephone_number": "818-731-8759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28141 BRANCH RD",
            "city": "CASTAIC",
            "state": "CA",
            "postal_code": "913843002",
            "telephone_number": "818-731-8759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULDIN",
        "first_name": "BLAKE",
        "middle_name": "STEVEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-13",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95038915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Ashor
• Cleofas Limiac Aspillaga
• Yusef Sohail Bawa, RCP, RN
• Michael Bezikian, PHARMD
• Boris Shnayder DDS. a Prof. Business Corp. (Paradise smile dental.)
• Bryan Watanabe DDS Dental Corporation (Hasley Canyon Dental Group)
• Shannon Andrade Calvillo
• Christianne Cardriche, LMFT
• Castaic Dental Center
• Castaic Urgent Care, Inc.

• Psychiatric/Mental Health Nurse Practitioner in Castaic, CA
• Providers in Castaic, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.