Jessica R Boulter, is a
Student In An Organized Health Care Education/training Program based in Modesto, California. Jessica R Boulter is licensed to practice in California (license number ) and her current practice location is
416 Corson Ave, Modesto, California. She can be reached at her office (for appointments etc.) via phone at
(209) 284-0970.
NPI number for Jessica R Boulter is 1770276859 and her current mailing address is 416 Corson Ave, Modesto, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1770276859.
Healthcare Provider's Profile
| Full Name | Jessica R Boulter |
|---|
| Gender | Female |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 416 Corson Ave, Modesto, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1770276859
- Provider Enumeration Date: 06/02/2023
- Last Update Date: 06/02/2023
Medical Identifiers
Medical identifiers for Jessica R Boulter such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1770276859 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (California) | Secondary |
| 101YM0800X | Counselor - Mental Health | (California) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jessica R Boulter is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jessica R Boulter,
416 Corson Ave,
Modesto, CA 95350-5408
Ph: (209) 284-0970 | Jessica R Boulter,
416 Corson Ave,
Modesto, CA 95350-5408
Ph: (209) 284-0970 |
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