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KERRI N. BOUTELLE PHD
NPI 1780620906
Psychologist - Clinical in La Jolla, CA

Active since June 22, 2006
9500 GILMAN DRIVE MC 0985, UNIVERSITY OF CALIFORNIA SAN DIEGO, LA JOLLA, CA 92093(858) 534-8037(858) 534-6727 Get Directions Write a Review

NPPES record last updated: July 22, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kerri N. Boutelle Phd NPPES

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

KERRI N. BOUTELLE PHD (NPI 1780620906) is an individual clinical provider in La Jolla, California, licensed in California (PSY21823) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1780620906
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameKERRI N. BOUTELLECredential: PHD
Location Address9500 GILMAN DRIVE MC 0985, UNIVERSITY OF CALIFORNIA SAN DIEGOLa Jolla, CA 92093
Mailing AddressPo Box 232410San Diego, CA 92193-2410 · (858) 249-6748
Phone(858) 534-8037
Fax(858) 534-6727
Sole ProprietorNo
Enumeration DateJune 22, 2006
Last NPPES UpdateJuly 22, 2019
✔ NPI 1780620906 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CA · PSY21823
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
Also ListedPsychologist · Clinical Child & AdolescentTaxonomy 103TC2200X · License PSY21823 (CA)
9500 GILMAN DRIVE MC 0985, La Jolla, CA 92093
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Other Identifiers 11

Other205A4BOMN · Bcbs
Medicaid0491997MT
Other39136900WI · Wi Ma
Medicaid7777470SD
Other10387ND · Nd Ma
Other123420MN · Ucare
Other61-60634MN · Medica Choice & Primary
Medicaid923517500MN
OtherHP34903MN · Healthpartners
Other1019785MN · Preferred One
Other839397MN · Araz

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 Kerri Boutelle's NPI number?

The NPI number for Kerri Boutelle is 1780620906. It was assigned to this individual provider in the NPPES registry on June 22, 2006.

Where is Kerri Boutelle located?

Kerri Boutelle practices at 9500 Gilman Drive Mc 0985 University Of California San Diego, La Jolla, CA 92093. The listed phone number is (858) 534-8037.

What is Kerri Boutelle's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Kerri Boutelle was last updated on July 22, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.