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JODY A BOUMA N.P.
NPI 1841425279
Nurse Practitioner in Upland, CA

Active since May 29, 2009
1113 ALTA AVE STE 220, UPLAND, CA 91786(909) 985-1908(909) 985-5583 Get Directions Write a Review

NPPES record last updated: May 29, 2009. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Jody A Bouma N.p. NPPES

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

JODY A BOUMA N.P. (NPI 1841425279) is an individual nurse practitioner in Upland, California, licensed in California (17316) and active in the NPI registry since May 2009.

NPPES Registry Identity

NPI1841425279
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameJODY A BOUMACredential: N.P.
Location Address1113 ALTA AVE STE 220Upland, CA 91786-2803
Mailing Address1113 Alta Ave Ste 220Upland, CA 91786-2803 · (909) 985-1908 · Fax (909) 985-5583
Phone(909) 985-1908
Fax(909) 985-5583
Sole ProprietorNo
Enumeration DateMay 29, 2009
✔ NPI 1841425279 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in CA · 17316
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
1113 ALTA AVE STE 220, Upland, CA 91786
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Other Identifiers 1

Other17316CA · Nurse Practitioner Lic

Other Providers at the Same Location NPPES 2

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

JOANNE MARIE LISTER FNP C
Nurse Practitioner (Family)
1113 ALTA AVE STE 220
UPLAND, CA 91786
San Bernardino County (909) 985-1908
MRS. CHRISTA DANIELLE KRELLWITZ NP-C
Clinic/Center (Primary Care)
1113 ALTA AVE STE 220
UPLAND, CA 91786
San Bernardino County (909) 985-1908

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 Jody Bouma's NPI number?

The NPI number for Jody Bouma is 1841425279. It was assigned to this individual provider in the NPPES registry on May 29, 2009.

Where is Jody Bouma located?

Jody Bouma practices at 1113 Alta Ave Ste 220, Upland, CA 91786. The listed phone number is (909) 985-1908.

What is Jody Bouma's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Jody Bouma was last updated on May 29, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.