Individual provider Active NPI

Audrey E Boggs, PSY.D.

  • Clinical Psychologist
  • Calabasas, CA
National Provider Identifier
1932235256
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY22027 Issued in CA
Practice address
24151 Ventura Blvd Ste 120
Calabasas, CA 91302-1354
Phone
(855) 501-1004
NPI assigned
Feb 23, 2007
Last updated
Apr 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY22027 CA Primary
Clinical Child & Adolescent Psychologist 103TC2200X PSY22027 CA

Addresses

Primary practice location

24151 Ventura Blvd Ste 120
Calabasas, CA 91302-1354

Mailing address

3835 N Freeway Blvd Ste 100
Sacramento, CA 95834-1954

Other practice location 1

30200 Agoura Rd Ste 190
Agoura Hills, CA 91301-5431
Phone (818) 295-2428

Other practice location 2

5012 Chesebro Rd Ste 200
Agoura Hills, CA 91301-2287
Phone (925) 282-1778

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200408001917 CA Practitioner - Clinical Psychologist 6800225103 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY22027CAMDClinical Child & Adolescent Psychologist
22027CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc Clinical CurrentSince Mar 17, 2025 Accepting new patients
Jaime Elizabeth Medvene PHD a Professional Psychological Corpora Clinical CurrentSince Mar 1, 2021 Accepting new patients
Family Psychological Services Inc CurrentSince Mar 1, 2020 Accepting new patients

Locations

30200 Agoura Rd
Ste 190
Agoura Hills, CA 91301
Phone (818) 981-7845

30423 Canwood St
Ste 130
Agoura Hills, CA 91301
Phone (818) 707-7366

30495 Canwood St
Ste 101
Agoura Hills, CA 91301
Phone (818) 707-7366

5012 Chesebro Rd
Ste 200
Agoura Hills, CA 91301
Phone (614) 943-0819

2300 Boswell Rd
Ste 275
Chula Vista, CA 91914
Phone (585) 898-0612

6200 Wilshire Blvd
Ste 1410
Los Angeles, CA 90048
Phone (323) 403-0474

1001 Partridge Dr
Ste 110
Ventura, CA 93003

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.audreyboggs@148377.advancedmd-direct.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1932235256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 N FREEWAY BLVD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24151 VENTURA BLVD STE 120",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021354",
            "telephone_number": "855-501-1004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30200 Agoura Rd Ste 190",
            "address_purpose": "LOCATION",
            "city": "Agoura Hills",
            "state": "CA",
            "postal_code": "913015431",
            "country_code": "US",
            "telephone_number": "818-295-2428",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5012 Chesebro Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Agoura Hills",
            "state": "CA",
            "postal_code": "913012287",
            "country_code": "US",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOGGS",
        "first_name": "AUDREY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY22027",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY22027",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calabasas, CA

Sources for this page

Verify at the official NPI Registry.