Boutelle, Kerri N.

Boutelle, Kerri N. is an individual health care provider with primary practice located at 9500 Gilman Drive Mc 0985 University Of California San Diego, La Jolla CA 92093. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Boutelle, Kerri N. can be contacted via phone (858) 534-8037.

Contact Information

Primary practice address
9500 Gilman Drive Mc 0985 University Of California San Diego La Jolla CA 92093
Phone: (858) 534-8037
Fax: (858) 534-6727
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY21823 California
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X PSY21823 California

Profile Details

NPI number 1780620906
LBN Legal business name Boutelle, Kerri N.
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Jul 22nd, 2019 - about 7 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1780620906 NPPES
Minnesota Other 123420 UCARE
Minnesota Other 205A4BO UCARE
Minnesota MEDICAID 923517500 UCARE
Minnesota Other 10387 UCARE
Minnesota Other 61-60634 UCARE
Minnesota Other 839397 UCARE
Minnesota MEDICAID 7777470 UCARE
Minnesota MEDICAID 0491997 UCARE
Minnesota Other 1019785 UCARE
Minnesota Other 39136900 UCARE
Minnesota Other HP34903 UCARE

Popular Providers