Healthcare Provider Details

I. General information

NPI: 1447459730
Provider Name (Legal Business Name): JENNIFER BOONE PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 11/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1270 NATIVIDAD RD ROOM 200
SALINAS CA
93906-3122
US

IV. Provider business mailing address

PO BOX 1765
CARMEL CA
93921-1765
US

V. Phone/Fax

Practice location:
  • Phone: 831-784-2150
  • Fax:
Mailing address:
  • Phone: 408-898-6685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: