WANDA RAMONA BOUTTE (NPI# 1376980227) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376980227 |
| Entity Type | Individual |
| Full Name | WANDA RAMONA BOUTTE |
| Other Name | WANDA RAMONA BOUTTE |
| Practice Address |
401 Grand Ave Suite 380 Oakland CA 94610-5054 |
| Mailing Address |
2001 Shoreline Dr Apt 212 Alameda CA 94501-6106 |
| Practice Telephone | 5104691136 |
| Mailing Telephone | 5104691136 |
| Enumeration Date | 2013-06-02 |
| Last Update Date | 2016-10-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | 293646 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | ALAMEDA COUNTY BEHAVIORAL HEALTH CARE SERVICES | 1376980227 | 01 |
| CA | NORIDIAN MEDICARE | CA206171 | 01 |
| Street Address |
401 GRAND AVE SUITE 380 |
| City | OAKLAND |
| State | CA |
| Zip Code | 94610-5054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467523936 | Sandra Laneal Stultz | Marriage & Family Therapist | 401 Grand Ave, Suite 380, Oakland, CA 94610-5054 | 2006-11-13 |
| 1215301056 | Vernita A Marsh | Psychologist | 401 Grand Ave, Suite 380, Oakland, CA 94610-5054 | 2015-11-17 |
| 1407226467 | Briana Sherice Moore | Social Worker | 401 Grand Ave, Suite 380, Oakland, CA 94610-5054 | 2015-10-03 |
| 1417389248 | Princess Vernita Robinson | Counselor | 401 Grand Ave, Suite 200, Oakland, CA 94610-5054 | 2013-08-02 |
| 1629322383 | Jessica Soto | Counselor | 401 Grand Ave, Suite 500, Oakland, CA 94610-5054 | 2012-11-02 |
| 1407151194 | Jose Efrayn Salinas Jr. | Social Worker | 401 Grand Ave, Suite 200, Oakland, CA 94610-5054 | 2011-01-11 |
| 1326340977 | Yecenia Parra | Social Worker | 401 Grand Ave, Suite 200, Oakland, CA 94610-5054 | 2010-12-01 |
| 1053544064 | Julia Catherine Bailey | Social Worker | 401 Grand Ave, Suite 200, Oakland, CA 94610-5054 | 2009-08-25 |
| 1689807695 | Alba Espinal | Social Worker | 401 Grand Ave, Suite 200, Oakland, CA 94610-5054 | 2009-08-25 |
| 1033363023 | Preeti Bhardwaj | Social Worker | 401 Grand Ave, Suite 200, Oakland, CA 94610-5054 | 2008-11-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467944033 | Danielle Elissa Comerford | Marriage & Family Therapist | 370 Grand Ave Ste 4, Oakland, CA 94610 | 2018-05-30 |
| 1073042628 | Thien Lake Acupuncture | Clinic/Center | 3654 Grand Aveune, Oakland, CA 94610 | 2017-06-07 |
| 1508239302 | Montserrat Corsino | Acupuncturist | 493 Prince St, Oakland, CA 94610 | 2015-11-03 |
| 1376978593 | Mazen Abudllah Basidiq | Registered Nurse | 271 Jayne Ave. Suite # 11, Oakland, CA 94610 | 2013-09-06 |
| 1740523026 | Katiah Llerena | Psychologist | 414 Lake Park Ave, #595, Oakland, CA 94610 | 2013-04-04 |
| 1033459409 | Shelly Lynn Henderson-hansen | Speech-Language Pathologist | 3756 Grand Ave, Suite 401, Oakland, CA 94610 | 2013-02-22 |
| 1013267806 | Sara-jean Lizabeth Bartky | Speech-Language Pathologist | 55 Santa Clara Ave #203, Oakland, CA 94610 | 2012-09-19 |
| 1053667139 | Juanita Lerma Hernandez-morin | Counselor | 1375 55th Street, Emeryville, CA 94610 | 2012-07-26 |
| 1396030672 | Catherine Maness | Marriage & Family Therapist | 123 Bay Place, Ste 6, Oakland, CA 94610 | 2011-06-14 |
| 1871807529 | Jaime Beth Levy | Marriage & Family Therapist | 1001 Warfield Ave Apt 103, Oakland, CA 94610 | 2010-08-04 |
| Find all providers in zip 94610 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053501353 | Jan Tatarsky | Developmental Therapist | 747 52nd St, Oakland, CA 94609-1809 | 2007-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154971745 | Natalie M Maddison | Developmental Therapist | 4397 Tujunga Ave, Studio City, CA 91604 | 2019-09-16 |
| 1962055426 | Bryan C Dunn | Developmental Therapist | 12180 Ridgecrest Rd Ste 508, Victorville, CA 92395-5903 | 2019-07-23 |
| 1124532676 | Martha Maxim | Developmental Therapist | 3424 Rodney St, Rosamond, CA 93560-7607 | 2017-11-20 |
| 1013463363 | Waheeda Waheed | Developmental Therapist | 501 W Broadway, Suit 800, San Diego, CA 92101 | 2016-08-28 |
| 1629427935 | Keelan Tobia | Developmental Therapist | 501 W Broadway, Suite 800, San Diego, CA 92101 | 2016-06-07 |
| 1942655386 | Lisa Annette Friddle | Developmental Therapist | 45198 Wiki Cir, Temecula, CA 92592-1348 | 2016-05-03 |
| 1790145316 | Jessica Vigil | Developmental Therapist | 414 Oxford St, Hayward, CA 94541-2225 | 2016-02-24 |
| 1497110142 | Vedrana Dujic-carew | Developmental Therapist | 560 Haight St., #104, San Francisco, CA 94117-3459 | 2015-12-23 |
| 1275907750 | Raveen Kallash | Developmental Therapist | 560 Haight St Apt 104, San Francisco, CA 94117-3444 | 2015-11-19 |
| 1104203520 | Megan Alders | Developmental Therapist | 21 Salinger Ct, Coto De Caza, CA 92679-5153 | 2015-05-06 |
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| 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.