Boucher, David Alan
Boucher, David Alan is an sole proprietor health care provider with primary practice located at 3633 Camino Del Rio South Suite 102, San Diego CA 92108-4012. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Boucher, David Alan can be contacted via phone (619) 296-8097.Contact Information
Primary practice address
3633 Camino Del Rio South Suite 102
San Diego CA 92108-4012
Phone: (619) 296-8097
Fax: (619) 260-1036
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PSY14085 | California |
Profile Details
NPI number | 1518966340 |
---|---|
LBN Legal business name | Boucher, David Alan |
Credentials | PH.D. |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jul 14th, 2005 |
Last updated | Feb 28th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1518966340 | NPPES |
California | MEDICAID | PSY140850 |
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