CARISA BOUDREAUX
NPI 1114400801
Student in an Organized Health Care Education/Training Program in Los Angeles, CA

Active since September 10, 2018
1224 VINE ST, LOS ANGELES, CA 90038(323) 769-6100 Get Directions Write a Review

NPPES record last updated: September 10, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Carisa Boudreaux NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARISA BOUDREAUX (NPI 1114400801) is an individual student in an organized health care education/training program in Los Angeles, California and active in the NPI registry since September 2018.

NPPES Registry Identity

NPI1114400801
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameCARISA BOUDREAUX
Location Address1224 VINE STLos Angeles, CA 90038-1612
Mailing Address1224 Vine StLos Angeles, CA 90038-1612
Sole ProprietorNo
Enumeration DateSeptember 10, 2018
NPI 1114400801 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1224 VINE ST, Los Angeles, CA 90038

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker (Clinical)
1224 VINE ST
LOS ANGELES, CA 90038
Counselor (Mental Health)
1224 VINE ST
LOS ANGELES, CA 90038
Social Worker (Clinical)
1224 VINE ST
LOS ANGELES, CA 90038
Case Manager/Care Coordinator
1224 VINE ST
LOS ANGELES, CA 90038
Case Manager/Care Coordinator
1224 VINE ST
LOS ANGELES, CA 90038
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1224 VINE ST
LOS ANGELES, CA 90038
Social Worker (Clinical)
1224 VINE ST, SUITE 101
LOS ANGELES, CA 90038
Social Worker (Clinical)
1224 VINE ST
LOS ANGELES, CA 90038

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carisa Boudreaux's NPI number?

The NPI number for Carisa Boudreaux is 1114400801. It was assigned to this individual provider in the NPPES registry on September 10, 2018.

Where is Carisa Boudreaux located?

Carisa Boudreaux practices at 1224 Vine St, Los Angeles, CA 90038. The listed phone number is (323) 769-6100.

What is Carisa Boudreaux's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Carisa Boudreaux was last updated on September 10, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.