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:
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Health care specialties

SpecialtyCodeLicense #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 15 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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Identifiers

StateTypeNumberIssuer
All States NPI 1518966340 NPPES
California MEDICAID PSY140850

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