Healthcare Provider Details

I. General information

NPI: 1437098621
Provider Name (Legal Business Name): WILDFLOWER PEDIATRICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 ILAHEE LN
CHICO CA
95973-7205
US

IV. Provider business mailing address

19 ILAHEE LN
CHICO CA
95973-7205
US

V. Phone/Fax

Practice location:
  • Phone: 530-570-0377
  • Fax: 530-898-1204
Mailing address:
  • Phone: 530-570-0377
  • Fax: 530-898-1204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: REBECCA BOENING
Title or Position: PRESIDENT
Credential: MD
Phone: 530-570-0377