ALISON ANN BOUDREAUX (NPI# 1093782120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093782120 |
| Entity Type | Individual |
| Full Name | ALISON ANN BOUDREAUX |
| Credential | M.D. |
| Practice Address |
2625 Fair Oaks Blvd Suite 1 Sacramento CA 95864-4936 |
| Practice Telephone | 9166463376 |
| Practice Fax Number | 9166463336 |
| Mailing Telephone | 9166463376 |
| Mailing Fax Number | 9166463336 |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2013-04-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | G076779 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE LICENSE | G076779 | 01 |
| CA | TAX ID | 43-2054849 | 01 |
| DEA NUMBER | BB4233627 | 01 |
| Street Address |
2625 FAIR OAKS BLVD SUITE 1 |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95864-4936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821474230 | Supinder Kaur Randhawa | Nurse Practitioner | 2625 Fair Oaks Blvd, Sacramento, CA 95864-4936 | 2015-08-07 |
| 1811323710 | Emily Renee Reisinger | Physician Assistant | 2625 Fair Oaks Blvd, #1, Sacramento, CA 95864 | 2013-09-24 |
| 1659408771 | Jacqueline M Calkin Md and Alison A Boudreaux Md A Professional Medica | Dermatology | 2625 Fair Oaks Blvd, Suite 1, Sacramento, CA 95864-4936 | 2007-02-27 |
| 1871561589 | Jacqueline Marie Calkin | Dermatology | 2625 Fair Oaks Blvd, Sacramento, CA 95864-4936 | 2006-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407239403 | Neda Afshar | Nurse Practitioner | 840 Laverstock Way, Sacramento, CA 95864 | 2015-07-08 |
| 1952738270 | Marshall Gollub | Psychiatry & Neurology | 1400 Jonas Ave., Sacramento, CA 95864 | 2013-10-01 |
| 1235565573 | Peter Alexander Hagens Jr. | Pharmacist | 930 Somersby Way, Sacramento, CA 95864 | 2013-09-18 |
| 1700054020 | Summit Psychotherapy Associates, PC | Psychologist | 3610 American River Drive, Suite 140, Sacramento, CA 95864 | 2008-02-20 |
| 1619917887 | Jayanthi Meena Kasiraj | Psychologist | 2708 Latham Drive, Sacramento, CA 95864 | 2006-06-07 |
| 1790259141 | Elizabeth Morales | Behavior Technician | 591 Watt Ave, Sacramento, CA 95864 | 2019-01-18 |
| 1033636261 | Sarah Leary | Speech-Language Pathologist | 3205 Hurley Way, Sacramento, CA 95864 | 2017-08-28 |
| 1063933786 | Kirsten Elisabeth Sorensen | Pharmacist | 3240 Arden Way, Sacramento, CA 95864 | 2017-07-03 |
| 1104298033 | Bufcsac PC | Clinic/Center | 4345 Arden Way, Sacramento, CA 95864 | 2015-10-30 |
| 1255523569 | Susan L Boone | Dermatology | 9201 Big Horn Blvd, 2nd Floor, Sacramento, CA 95864 | 2007-08-10 |
| Find all providers in zip 95864 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871869115 | Davina Schulman | Dermatology | 2625 Fair Oaks Blvd Ste 1, Sacramento, CA 95864-4936 | 2012-03-30 |
| 1902123383 | Pantea Hashemi | Dermatology | 650 University Ave Ste 200, Sacramento, CA 95825 | 2010-04-26 |
| 1942468962 | Jayne Joo | Dermatology | 3301 C St Ste 1400, Sacramento, CA 95816-3367 | 2008-05-27 |
| 1932308681 | Peggy Wu | Dermatology | 3301 C St Ste 1300, Sacramento, CA 95816 | 2007-07-13 |
| 1487732160 | Douglas B. Patton | Dermatology | 1020 29th St Ste 570a, Sacramento, CA 95816 | 2006-11-01 |
| 1447340849 | Lawrence J Bass | Dermatology | 5340 Elvas Avenue, Suite 600, Sacramento, CA 95819-2385 | 2006-10-14 |
| 1588602338 | William Henry Chan | Dermatology | 5525 Assembly Ct, #c, Sacramento, CA 95823-2608 | 2006-06-03 |
| 1649255068 | Thomas H King | Dermatology | 4680 Y Street, Suite 2100, Sacramento, CA 95817 | 2005-12-08 |
| 1730185695 | Michael Joseph Fazio | Dermatology | 2805 J Street, Suite 100, Sacramento, CA 95816 | 2005-06-24 |
| 1760485205 | John A Kasch | Dermatology | 2721 Capitol Ave, Sacramento, CA 95816-6004 | 2005-05-28 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95864 |
Please comment or provide details below to improve the information on ALISON ANN BOUDREAUX.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.