Indianna Mckenna Bouch, is a
Student In An Organized Health Care Education/training Program based in San Bernardino, California. Indianna Mckenna Bouch is licensed to practice in California (license number ) and her current practice location is
1950 S Sunwest Ln Ste 200, San Bernardino, California. She can be reached at her office (for appointments etc.) via phone at
(909) 252-4017.
NPI number for Indianna Mckenna Bouch is 1831806603 and her current mailing address is 1950 S Sunwest Ln Ste 200, San Bernardino, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1831806603.
Healthcare Provider's Profile
| Full Name | Indianna Mckenna Bouch |
|---|
| Gender | Female |
|---|
| Speciality | Student In An Organized Health Care Education/training Program |
|---|
| Location | 1950 S Sunwest Ln Ste 200, San Bernardino, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1831806603
- Provider Enumeration Date: 11/01/2022
- Last Update Date: 05/01/2024
Medical Identifiers
Medical identifiers for Indianna Mckenna Bouch such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1831806603 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (California) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (California) | Primary |
| 172V00000X | Community Health Worker | (California) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Indianna Mckenna Bouch is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Indianna Mckenna Bouch,
1950 S Sunwest Ln Ste 200,
San Bernardino, CA 92408-3248
Ph: () - | Indianna Mckenna Bouch,
1950 S Sunwest Ln Ste 200,
San Bernardino, CA 92408-3248
Ph: (909) 252-4017 |
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