PEDIATRIC NEURODEVELOPMENTAL & BEHAVIORAL CLINIC OF SOUTHERN OREGON
NPI 1619791415
Community/Behavioral Health in Medford, OR

Active since November 09, 2024
33 N CENTRAL AVE STE 317, MEDFORD, OR 97501(541) 227-2808(541) 227-2807 Get Directions Write a Review

NPPES record last updated: November 9, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Pediatric Neurodevelopmental & Behavioral Clinic Of Southern Oregon NPPES

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

PEDIATRIC NEURODEVELOPMENTAL & BEHAVIORAL CLINIC OF SOUTHERN OREGON (NPI 1619791415) is a healthcare organization registered as a community/behavioral health in Medford, Oregon and active in the NPI registry since November 2024. The organization lists Jennifer Boudreaux, Owner/provider, as its authorized official.

NPPES Registry Identity

NPI1619791415
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NamePEDIATRIC NEURODEVELOPMENTAL & BEHAVIORAL CLINIC OF SOUTHERN OREGON
Location Address33 N CENTRAL AVE STE 317Medford, OR 97501-5939
Mailing Address33 N Central Ave Ste 317Medford, OR 97501-5939 · (541) 227-2808 · Fax (541) 227-2807
Fax(541) 227-2807
Organization SubpartYesParent: Jennifer K Boudreaux, Cpnp, Pmhs, Llc
Authorized OfficialJennifer BoudreauxOwner/provider · (541) 324-3648
Enumeration DateNovember 9, 2024
NPPES CertifiedNovember 8, 2024
NPI 1619791415 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

33 N CENTRAL AVE STE 317, Medford, OR 97501

Other Providers at the Same Location NPPES

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

Nurse Practitioner (Pediatrics)
33 N CENTRAL AVE STE 317
MEDFORD, OR 97501

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 Pediatric Neurodevelopmental & Behavioral Clinic Of Southern Oregon's NPI number?

The NPI number for Pediatric Neurodevelopmental & Behavioral Clinic Of Southern Oregon is 1619791415. It was assigned to this organization in the NPPES registry on November 9, 2024.

Where is Pediatric Neurodevelopmental & Behavioral Clinic Of Southern Oregon located?

Pediatric Neurodevelopmental & Behavioral Clinic Of Southern Oregon is located at 33 N Central Ave Ste 317, Medford, OR 97501. The listed phone number is (541) 227-2808.

What is Pediatric Neurodevelopmental & Behavioral Clinic Of Southern Oregon's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Pediatric Neurodevelopmental & Behavioral Clinic Of Southern Oregon was last updated on November 9, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.