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General NPI Number Information
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NPI Number | 1356144166
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Entity Type | Individual
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Provider Name | MARIA D BOARDMAN
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Gender | Female
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Dates
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Enumeration Date | 03/28/2025
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 13333 PALMDALE RD
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City | VICTORVILLE
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State | CA
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Zip | 92392-9364
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Country | US
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Telephone | 760-487-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 10656 NAMBE RD # 1
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City | APPLE VALLEY
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State | CA
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Zip | 92308-8115
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Country | US
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Telephone | 760-490-5780
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | CA
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