Kerri N. Boutelle is a Clinical in La Jolla, California. Kerri N. Boutelle practices all healthcare services and medical treatments related to Clinical. The NPI Number for Kerri N. Boutelle is 1780620906. The last update date is 2019-07-22.
Kerri N. Boutelle's current location address is 9500 Gilman Drive Mc 0985, La Jolla, California. You can contact this provider via phone number 8585348037 and fax number 8585346727. The mailing address for Kerri N. Boutelle is 9500 Gilman Drive Mc 0985, La Jolla, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kerri N. Boutelle |
|---|---|
| Address | 9500 Gilman Drive Mc 0985, La Jolla, California |
| Phone Number | 8585348037 |
| Fax Number | 8585346727 |
| Sole Proprietor | N |
| Credentials | PHD |
NPI Number Detail
| NPI Number | 1780620906 |
|---|---|
| Provider Enumeration Date | 2006-06-22 |
| Last Updated Date | 2019-07-22 |
Provider Mailing Address Detail
| Address | 9500 Gilman Drive Mc 0985 |
|---|---|
| City | La Jolla |
| State | California (CA) |
| Post Code | 92093 |
| Phone Number | 8585348037 |
| Fax Number | 8585346727 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | PSY21823 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 123420 | MN | UCARE | |
| 205A4BO | MN | BCBS | |
| 923517500 | MN | -- | |
| 10387 | ND | ND MA | |
| 61-60634 | MN | MEDICA CHOICE & PRIMARY | |
| 839397 | MN | ARAZ | |
| 7777470 | SD | -- | |
| 491997 | MT | -- | |
| 1019785 | MN | PREFERRED ONE | |
| 39136900 | WI | WI MA |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Kerri N. Boutelle by the Centers for Medicare & Medicaid Services?
The Kerri N. Boutelle has been assigned the NPI (National Provider Identifier) 1780620906 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete address where Kerri N. Boutelle is physically located?
The Kerri N. Boutelle is situated at the following address: 9500 Gilman Drive Mc 0985, La Jolla, CA 92093.
What is the Kerri N. Boutelle's area of specialization and corresponding taxonomy classification?
The Kerri N. Boutelle's specialty field is Clinical, and it falls under the taxonomy code 103Tc0700X, which categorizes healthcare providers based on their specialties.
When was the Kerri N. Boutelle's 1780620906 issued?
The Kerri N. Boutelle's 1780620906 was issued on 2006-06-22.
When was the information pertaining to Kerri N. Boutelle most recently updated or revised?
The details related to Kerri N. Boutelle, including its address, specialty, and other relevant information, were last updated or revised on 2019-07-22.
NPI Number: 1851381982
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