Healthcare Provider Details

I. General information

NPI: 1851181689
Provider Name (Legal Business Name): ANGELA MARIA BOESHANS MSN, FNP-BC, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA MARIA HALPERN BSN, RN

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4341B GOLDEN CENTER DR
PLACERVILLE CA
95667-6260
US

IV. Provider business mailing address

4341B GOLDEN CENTER DR
PLACERVILLE CA
95667-6260
US

V. Phone/Fax

Practice location:
  • Phone: 530-621-3600
  • Fax: 530-748-0325
Mailing address:
  • Phone: 530-621-3600
  • Fax: 530-748-0325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95035807
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number512880
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: