Provider Demographics
NPI: | 1558183095 |
---|---|
Name: | BOYCE, MEGAN |
Entity type: | Individual |
Prefix: | |
First Name: | MEGAN |
Middle Name: | |
Last Name: | BOYCE |
Suffix: | |
Gender: | F |
Credentials: | |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 1400 N JOHNSON AVE STE 101 |
Mailing Address - Street 2: | |
Mailing Address - City: | EL CAJON |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 92020-1651 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2506 MARKET ST |
Practice Address - Street 2: | |
Practice Address - City: | SAN DIEGO |
Practice Address - State: | CA |
Practice Address - Zip Code: | 92102-3010 |
Practice Address - Country: | US |
Practice Address - Phone: | 619-294-5760 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2024-10-28 |
Last Update Date: | 2024-10-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
No | 146D00000X | Emergency Medical Service Providers | Personal Emergency Response Attendant | Group - Multi-Specialty | |
No | 146L00000X | Emergency Medical Service Providers | Emergency Medical Technician, Paramedic | Group - Multi-Specialty | |
No | 146M00000X | Emergency Medical Service Providers | Emergency Medical Technician, Intermediate | Group - Multi-Specialty | |
No | 146N00000X | Emergency Medical Service Providers | Emergency Medical Technician, Basic | Group - Multi-Specialty | |
No | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | Group - Multi-Specialty | |
No | 225800000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Recreation Therapist | Group - Multi-Specialty | |
No | 226000000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Recreational Therapist Assistant | Group - Multi-Specialty | |
No | 374K00000X | Nursing Service Related Providers | Religious Nonmedical Practitioner | Group - Multi-Specialty |