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NPI Code Detail

MEDICARE: DR. AUDREY E BOGGS PSY.D.

MEDICARE: DR. AUDREY E BOGGS PSY.D.
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
1103TC0700XClinical PsychologistPSY22027CA
2103TC2200XClinical Child & Adolescent PsychologistPSY22027CA

General Provider Information

NPI Number : 1932235256
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AUDREY E BOGGS PSY.D.
Provider Business Mailing Address
First Line : 5012 CHESEBRO RD STE 200
Second Line :
City : AGOURA HILLS
State : CA
Zip : 91301-2287
Country : US
Telephone Number : 925-282-1778
Fax Number : 415-296-5299
Provider Business Practice Location Address
First Line : 5012 CHESEBRO RD STE 200
Second Line :
City : AGOURA HILLS
State : CA
Zip : 91301-2287
Country : US
Telephone Number : 925-282-1778
Fax Number : 415-296-5299
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2007
Last Update Date : 04/17/2025

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