Mikisa Ann Boone
Counselor, Addiction (Substance Use Disorder) in San Pablo, CA. Individual provider (NPI-1).
NPI number1952255994
StatusActive
Last updated in NPPESFeb 25, 2026
Details
- NPI
- 1952255994
- Entity type
- Individual (NPI-1)
- Name
- Mikisa Ann Boone
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 25, 2026
- Certification date
- Feb 25, 2026
- Last updated
- Feb 25, 2026
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 |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 23429 | CA | Yes |
Practice location
1901 Church LnSan Pablo, CA 94806-3707
Phone 510-236-3134
Mailing address
1901 Church LnSan Pablo, CA 94806-3707
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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All 44 Addiction (Substance Use Disorder) Counselor providers in San Pablo · All 643 providers in San Pablo
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