Individual provider · NPI-1
Eric Brandon Boswell
Day Training/Habilitation Specialist · Roseville, CA
NPI number1235823089
StatusActive
Last updated in NPPESApr 24, 2025
Details
- NPI
- 1235823089
- Entity type
- Individual (NPI-1)
- Name
- Eric Brandon Boswell
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 5, 2023
- Certification date
- Apr 24, 2025
- Last updated
- Apr 24, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 373H00000X | Day Training/Habilitation Specialist | – | CA | Yes |
| 171M00000X | Case Manager/Care Coordinator | – | – | |
| 172V00000X | Community Health Worker | – | – |
Practice location
101 Cirby Hills DrRoseville, CA 95678-4360
Phone 916-784-8874
Mailing address
101 Cirby Hills DrRoseville, CA 95678-4360
Phone 916-784-8874
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