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NPI Code Detail

MEDICARE: KRISTA GAGNIER BOSTIC

MEDICARE: KRISTA GAGNIER BOSTIC
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
1163W00000XRegistered Nurse95075704CA

General Provider Information

NPI Number : 1194650150
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTA GAGNIER BOSTIC
Provider Business Mailing Address
First Line : 1420 DORSET AVE
Second Line :
City : THOUSAND OAKS
State : CA
Zip : 91360-3407
Country : US
Telephone Number : 818-268-6088
Fax Number :
Provider Business Practice Location Address
First Line : 1420 DORSET AVE
Second Line :
City : THOUSAND OAKS
State : CA
Zip : 91360-3407
Country : US
Telephone Number : 818-268-6088
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2026
Last Update Date : 06/12/2026

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Directions to “ KRISTA GAGNIER BOSTIC ” Practice Location

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