Katrina Boom, M.A. CCC-SLP
Speech-Language Pathologist, in Carlsbad, CA. Individual provider (NPI-1).
NPI number1003535519
StatusActive
Last updated in NPPESAug 26, 2022
Details
- NPI
- 1003535519
- Entity type
- Individual (NPI-1)
- Name
- Katrina Boom
- Credential
- M.A. CCC-SLP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 26, 2022
- Certification date
- Aug 26, 2022
- Last updated
- Aug 26, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | 21164 | CA | Yes |
Practice location
1251 Knowles AveCarlsbad, CA 92008-1545
Phone 408-921-9804
Mailing address
1251 Knowles AveCarlsbad, CA 92008-1545
Phone 408-921-9804
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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