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Ken Boston
Mental Health Counselor in Santa Cruz, California
NPI 1992926323

Ken Boston is a Mental Health Counselor based in Santa Cruz, CA and is specialized in Mental Health. Ken Boston practices in Santa Cruz, CA. The NPI Number for Ken Boston is 1992926323 and holds a License No. (California).

The current practice location address for Ken Boston is 1400 Emeline Ave, Santa Cruz, CA and can be reached out via phone at 831-454-4170 and via fax at 831-454-4663.

Location: 1400 Emeline Ave, Santa Cruz, CA, 95060-2103
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1992926323
Provider Name
Ken Boston
Credential
Provider Entity Type
Individual
Gender
Male
Address
1400 Emeline Ave, Santa Cruz, CA, 95060-2103
Phone Number
831-454-4170
Fax Number
831-454-4663
Provider Enumeration Date
05/02/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
FHC70042F 01 CA COUNTY OF SANTA CRUZ MEDI-CAL GROUP PTAN#
FHC70044F 01 CA COUNTY OF SANTA CRUZ MEDI-CAL GROUP PTAN#
institution
Provider Business Practice Location Address Details
Address
1400 Emeline Ave
City
Santa Cruz
State
California
Zip
95060-1976
Phone Number
831-454-4170
Fax Number
831-454-4663
person
Provider Business Mailing Address Details
Address
1400 Emeline Ave
City
Santa Cruz
State
California
Zip
95060-1976
Phone Number
831-454-4170
Fax Number
831-454-4663
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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