Healthcare Provider Details

I. General information

NPI: 1982194379
Provider Name (Legal Business Name): WESLEY JAMES BOATMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2018
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1236 CHAPALA ST
SANTA BARBARA CA
93101-3116
US

IV. Provider business mailing address

3456 VIA CORTEZ
LOMPOC CA
93436-2144
US

V. Phone/Fax

Practice location:
  • Phone: 805-741-7460
  • Fax:
Mailing address:
  • Phone: 805-742-6067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: