Boutelle, Ronald Charles

Boutelle, Ronald Charles is an sole proprietor health care provider with primary practice located at 12304 Santa Monica Blvd Suite 106, Los Angeles CA 90025-2551. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychoanalysis, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Boutelle, Ronald Charles can be contacted via phone (310) 317-6784.

Contact Information

Primary practice address
12304 Santa Monica Blvd Suite 106 Los Angeles CA 90025-2551
Phone: (310) 317-6784
Fax: (310) 317-6784
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY10792 California
Behavioral Health & Social Service Providers / Psychoanalysis 103TP0814X PSY10792 California
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY10792 California

Profile Details

NPI number 1316983562
LBN Legal business name Boutelle, Ronald Charles
Credentials PHD, PSYD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 22nd, 2006
Last updated Jul 8th, 2007 - about 17 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.

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