Healthcare Provider Details

I. General information

NPI: 1851295976
Provider Name (Legal Business Name): LUKE JAMESGEORGE BOOLE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1531 WALTON ST
OCEANSIDE CA
92058-2238
US

IV. Provider business mailing address

1531 WALTON ST
OCEANSIDE CA
92058-2238
US

V. Phone/Fax

Practice location:
  • Phone: 760-638-5935
  • Fax:
Mailing address:
  • Phone: 760-638-5935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT00053-A
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number160051
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: