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General NPI Number Information
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NPI Number | 1225612583
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Entity Type | Individual
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Provider Name | WHITNEY LYNN BOULTON DC
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Gender | Female
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Dates
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Enumeration Date | 05/11/2021
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Last Update Date | 01/03/2023
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Provider Practice Location Address
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Address Line | 300 S EL CAMINO REAL STE 202
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City | SAN CLEMENTE
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State | CA
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Zip | 92672-4070
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Country | US
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Telephone | 949-232-0523
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Fax |
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Provider Business Mailing Address
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Address Line | 316 CAZADOR LN # C
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City | SAN CLEMENTE
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State | CA
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Zip | 92672-6643
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Country | US
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Telephone | 916-337-1404
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Fax | 949-359-8386
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC36084
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License Number State | CA
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