Healthcare Provider Details

I. General information

NPI: 1669062022
Provider Name (Legal Business Name): ALISTER BOHEGIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2021
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11990 HERITAGE OAK PL STE 4B
AUBURN CA
95603-2405
US

IV. Provider business mailing address

110 GATEWAY DR STE 210
LINCOLN CA
95648-3306
US

V. Phone/Fax

Practice location:
  • Phone: 530-499-8859
  • Fax:
Mailing address:
  • Phone: 916-645-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: