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NPI Code Detail

MEDICARE: BEVERLY BOONE

MEDICARE: BEVERLY BOONE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063009884
Entity Type Code : Individual
Provider Name (Legal Business Name) : BEVERLY BOONE
Provider Business Mailing Address
First Line : 1816 PORTOFINO DR
Second Line :
City : OCEANSIDE
State : CA
Zip : 92054-6130
Country : US
Telephone Number : 760-433-6361
Fax Number :
Provider Business Practice Location Address
First Line : 1816 PORTOFINO DR
Second Line :
City : OCEANSIDE
State : CA
Zip : 92054-6130
Country : US
Telephone Number : 760-433-6361
Fax Number : 760-439-7402
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2020
Last Update Date : 12/28/2020

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92054-6130
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Directions to “ BEVERLY BOONE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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